LEE SHOOP, MD

NPI 1023143146, individual, Red Bluff, CA, Family Medicine

Evidence tier

informational

Medicaid dollars per patient on code 99213 ($794 per patient-month) sit in the top 5% of every provider billing that code.

score 35 of 100, rank 10321, $371K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	LEE SHOOP, MD
Type	Individual
Status	Active
NPI issued	February 21, 2007, last updated January 8, 2016
Practice location	2450 SISTER MARY COLUMBA DR, Red Bluff, CA 96080-4356, 530-527-0414
Specialties	Family Medicine (207Q00000X, primary, license G057728 CA)

Procedures billed

The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.

Medicaid, largest codes

code	what it is	paid	share	per patient-month	typical	rank among providers
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$418K	59%	$297	$44 (top 5% from $110)	99th percentile
T1015	Medicaid service code	$222K	31%	$794	$182 (top 5% from $488)	98th percentile
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a t	$69K	10%	$335	$20 (top 5% from $124)	99th percentile
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	$18	0%	$0.44	$28 (top 5% from $147)	too few months to rank
90686	Influenza vaccine, quadrivalent, preservative free, 0.5 ml dosage	$0	0%	$0.00	$2.30 (top 5% from $20)	too few months to rank

Medicare Part B 2024, largest codes

code	what it is	services	beneficiaries	paid	submitted per service	allowed per service	charge to allowed	usual for this code
87637	Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus	31	30	$4K	$180	$140	1.3x	2.1x (90th percentile 3.0x)
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	101	87	$4K	$59	$58	1.0x	2.2x (90th percentile 3.8x)
83037	Hemoglobin a1c level, by device for home use	125	96	$1K	$45	$10	4.7x	3.2x (90th percentile 6.3x)
81002	Urinalysis, manual test	80	68	$273	$14	$3	4.1x	3.5x (90th percentile 7.6x)
93005	Routine electrocardiogram (ecg) using at least 12 leads with tracing	42	40	$147	$19	$7	2.9x	6.3x (90th percentile 18.0x)
82962	Blood glucose (sugar) test performed by hand-held instrument	12	12	$39	$10	$3	3.1x	3.7x (90th percentile 8.1x)

A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.

In this area

8 providers in Tehama County, CA carry an indicator in the public record, with $3.1M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 2. 1 is tier 1: documented action, then payment.

tier	provider	at stake	why
1	JAMES OOI Corning, CA, ranked 373	$2K	Listed on the CA Medicaid exclusion list since October 18, 2022. Medicaid still paid claims in 2 later months, $1,720 in total.
3	RED BLUFF HEALTH CARE, INC. Red Bluff, CA, ranked 1905	$0	Part of provider network D1-00092, ranked 92 nationally.
3	SHASTA VIEW CARE CENTER LLC Red Bluff, CA, ranked 2426	$0	Part of provider network D1-00087, ranked 87 nationally.
4	KERRY WAITS Red Bluff, CA, ranked 7772	$1.3M	Hours beyond a day in 10 months under one organization, which can be supervisory billing. Records needed. and 1 more
5	JACOB STROMAN Red Bluff, CA, ranked 10171	$747K	Medicaid dollars per patient on code 97110 ($1519 per patient-month) sit in the top 5% of every provider billing that code.
5	BRIAN LAIR Red Bluff, CA, ranked 10259	$506K	Medicaid dollars per patient on code G0467 ($343 per patient-month) sit in the top 5% of every provider billing that code.
5	JAMES MONTANA Red Bluff, CA, ranked 10356	$261K	Medicaid dollars per patient on code 97140 ($1251 per patient-month) sit in the top 5% of every provider billing that code.
5	DANIEL LEAVITT Red Bluff, CA, ranked 11369	$299K

Recent enforcement in CA

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJPleaded guiltyAug 27, 2026

Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare

Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.

DOJCivil settlementAug 26, 2026

DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests

DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit

Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.

DOJCivil settlementAug 24, 2026

Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit

Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.

Referral packet

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