Providers
CHARLEY ALLEN ROMAN, NP-C
NPI 1063968469, individual, Chillicothe, OH, Nurse Practitioner, Family
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 5 months, but with up to 659 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 51 of 100, rank 9185, $550K at stake
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 30.6 | 22.8 | 15.2 | 20.7 | 619 | 3 | 90837 99203 99213 99354 | $65K |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 32.1 | 26.9 | 18.0 | 24.2 | 659 | 3 | 90791 90837 99203 99213 99354 | $78K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 31.4 | 27.6 | 18.4 | 27.2 | 620 | 3 | 90791 90837 99203 99213 99354 | $78K |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 34.9 | 29.5 | 19.7 | 27.6 | 501 | 3 | 90791 90837 99203 99213 99354 | $74K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 38.3 | 31.9 | 21.3 | 28.7 | 552 | 3 | 90791 90837 99203 99213 99354 | $88K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CHARLEY ALLEN ROMAN, NP-C |
| Type | Individual |
| Status | Active |
| NPI issued | August 26, 2016, last updated August 30, 2019 |
| Practice location | 17273 STATE ROUTE 104, Chillicothe, OH 45601-9718, 740-773-1141 |
| Specialties | Nurse Practitioner, Family (363LF0000X, primary, license APRN.CNP.019791 OH) |
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 | $1.0M | 49% | $49 | $44 (top 5% from $110) | 58th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $671K | 32% | $363 | $191 (top 5% from $442) | 91st percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $143K | 7% | $52 | $67 (top 5% from $121) | 27th percentile | |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | $88K | 4% | $48 | $44 (top 5% from $70) | 61st percentile | |
| 99354 | Prolonged service outpatient first hour (retired 2023) | $64K | 3% | $386 | $78 (top 5% from $222) | 100th percentile | |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | $24K | 1% | $13 | $12 (top 5% from $18) | 54th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $19K | 1% | $30 | $32 (top 5% from $49) | 44th percentile | |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | $16K | 1% | $21 | $20 (top 5% from $39) | 53rd percentile |
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 |
|---|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 178 | 110 | $6K | $108 | $73 | 1.5x | 2.2x (90th percentile 3.8x) |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 13 | 13 | $654 | $70 | $50 | 1.4x | 2.4x (90th percentile 3.7x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 11 | 11 | $307 | $158 | $90 | 1.8x | 2.4x (90th percentile 3.9x) |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 14 | 14 | $227 | $30 | $16 | 1.8x | 2.5x (90th percentile 3.9x) |
| 81002 | Urinalysis, manual test | 15 | 12 | $51 | $14 | $3 | 4.2x | 3.5x (90th percentile 7.6x) |
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
7 providers in Ross County, OH carry an indicator in the public record, with $3.5M at stake between them. The most common is part of a provider network, on 5 of them, followed by more hours than a day holds on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | ADENA HOSPICE, LLC Chillicothe, OH, ranked 812 | $158K |
|
| 3 | NATIONAL CHURCH RESIDENCES AT HOME HOSPICE Chillicothe, OH, ranked 985 | $1.8M |
|
| 3 | ADENA HOME HEALTH, LLC Chillicothe, OH, ranked 1469 | $28K |
|
| 3 | NATIONAL CHURCH RESIDENCES AT HOME, INC Chillicothe, OH, ranked 5030 | $0 |
|
| 3 | TRADITIONS AT CHILLICOTHE Chillicothe, OH, ranked 6023 | $0 |
|
| 4 | ALVIN MARES Chillicothe, OH, ranked 8201 | $850K |
|
| 5 | JACQUELYN CARO Chillicothe, OH, ranked 11132 | $698K |
Recent enforcement in OH
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Ohio Dentist Agrees to Pay $500,000 to Resolve Allegations of Submitting False Claims to Medicaid
Meckler billed the Ohio Department of Medicaid for services provided by Ball, who was excluded from the Medicaid program, by listing Meckler as the rendering provider instead of Ball.
DOJSentencedJun 15, 2026
Ohio Doctor Ordered to Pay Nearly $1M for Facilitating Fraud on Medicare
A physician working as an independent contractor for a telemedicine company signed doctor's orders for durable medical equipment braces and genetic testing without meaningfully reviewing patient records or performing required in-person assessments, and those orders were used to bill Medicare more than $1,842,524.
DOJCivil settlementApr 2, 2026
Trinity Hospital Agrees to Pay $1.7M to Resolve Alleged Stark Law Violations
Trinity agreed to pay $1.7 million to resolve allegations that from 2014 through 2020 it made improper financial contributions to two referring physicians through office space rental arrangements that exceeded fair market value, in violation of the Stark Law.
DOJComplaint filedFeb 20, 2026
Justice Department Sues OhioHealth for Anticompetitive Healthcare Contracts That Increase Costs for Ohio Patients
The Justice Department and Ohio Attorney General filed a civil antitrust complaint alleging OhioHealth used its market power to impose contractual restrictions that prevent insurers from offering lower-cost health plans and limit access to price information.
DOJSentencedJan 14, 2026
Ohio Doctor Sentenced to Prison for $14M Healthcare Fraud Scheme
A licensed Ohio physician employed by two Florida telemedicine companies signed pre-completed orders for durable medical equipment and cancer genetic testing, falsely affirming he had examined the patients, causing more than $14.5 million in fraudulent Medicare claims.
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.