Providers
All 16 in CA
MARK W. RAMUS, M.D.
NPI 1043375280, individual, Redding, CA, Pathology, Anatomic Pathology & Clinical Pathology
1
Evidence tier
documented action, then payment
- Listed on the CA Medicaid exclusion list since July 14, 2023.
- Medicaid still paid claims in 14 later months, $243,861 in total.
score 95 of 100, rank 107, $244K at stake
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| CA Medicaid exclusion list ca medi-cal suspended & ineligible provider list (july 2026) | Exact NPI, name verified | Jul 14, 2023 | still open | 14 | Aug 2023 | Sep 2024 | $244K | $227K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MARK W. RAMUS, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | December 27, 2006, last updated July 8, 2007 |
| Practice location | 2036 RAILROAD AVE, Redding, CA 96001-1801, 530-255-1000 |
| Specialties | Pathology, Anatomic Pathology & Clinical Pathology (207ZP0102X, primary, license A73453 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 | |
|---|---|---|---|---|---|---|---|
| 80053 | Blood test, comprehensive group of blood chemicals | $214K | 13% | $3.59 | $8.38 (top 5% from $44) | 25th percentile | |
| 85025 | Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count | $175K | 11% | $2.89 | $5.69 (top 5% from $25) | 29th percentile | |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | $133K | 8% | $52 | $43 (top 5% from $119) | 66th percentile | |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | $90K | 6% | $80 | $66 (top 5% from $127) | 73rd percentile | |
| 83880 | Natriuretic peptide (heart and blood vessel protein) level | $66K | 4% | $9.62 | $15 (top 5% from $39) | 40th percentile | |
| 83735 | Magnesium level | $64K | 4% | $4.02 | $3.71 (top 5% from $16) | 53rd percentile | |
| 80048 | Blood test, basic group of blood chemicals (calcium, total) | $63K | 4% | $3.74 | $6.72 (top 5% from $30) | 31st percentile | |
| 87040 | Bacterial blood culture | $53K | 3% | $3.60 | $6.88 (top 5% from $33) | 39th percentile |
In this area
16 providers in Shasta County, CA carry an indicator in the public record, with $9.8M at stake between them. The most common is more hours than a day holds, on 12 of them, followed by part of a provider network on 4.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | NORTHERN CALIFORNIA REHABILITATION HOSPITAL, LLC Redding, CA, ranked 2241 | $0 |
|
| 3 | SOJOURN HOSPICE & PALLIATIVE CARE - REDDING, LLC. Redding, CA, ranked 3041 | $0 |
|
| 3 | LHCG XXXVIII, LLC Redding, CA, ranked 3156 | $0 |
|
| 3 | DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA Redding, CA, ranked 4220 | $0 |
|
| 4 | ORNELLA ADDONIZIO Redding, CA, ranked 7725 | $1.7M |
|
| 4 | BRIAN BAAS Anderson, CA, ranked 7755 | $1.4M |
|
| 4 | CHRISTOPHER WILLS Redding, CA, ranked 8658 | $2.4M |
|
| 4 | NIRMEET RAI Redding, CA, ranked 9780 | $413 |
|
Recent enforcement in CA
All releasesDepartment 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
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.