ROSALY MARIE DIAZ TORRUELLAS, M.D

NPI 1114340858, individual, Las Vegas, NV, Internal Medicine

Evidence tier

structure or single-organization volume

Hours beyond a day in 17 months, but with up to 561 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
Records needed.
Medicaid dollars per patient on code 90876 ($952 per patient-month) sit in the top 5% of every provider billing that code.

score 56 of 100, rank 7523, $3.5M 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
Jul 2023	More hours than a day holds, even counting one unit per claim line	31.6	30.3	20.2	29.8	392	3	90876 96132 96133 96136 96137 96158 99211 99213 99214	$108K
Aug 2023	More hours than a day holds, even counting one unit per claim line	38.2	38.2	25.5	34.4	369	3	90876 96132 96133 96136 96137 99211 99213 99214	$137K
Sep 2023	More hours than a day holds, even counting one unit per claim line	37.5	31.1	20.7	29.6	429	2	90876 96158 99211 99213 99214 99232	$108K
Oct 2023	More hours than a day holds, even counting one unit per claim line	40.3	41.6	27.7	39.1	336	2	90876 99211 99213 99214 99232	$151K
Nov 2023	More hours than a day holds, even counting one unit per claim line	49.4	51.5	34.3	46.8	379	2	90876 99211 99213 99214	$181K
Dec 2023	More hours than a day holds, even counting one unit per claim line	61.9	68.0	45.3	66.9	505	2	90876 96132 96136 99211 99213 99214	$233K
Jan 2024	More hours than a day holds, even counting one unit per claim line	59.3	60.5	40.3	54.4	347	2	90876 99211 99213 99214	$224K
Feb 2024	More hours than a day holds, even counting one unit per claim line	65.5	70.1	46.8	64.6	486	2	90876 96132 96136 99211 99213 99214	$227K
Mar 2024	More hours than a day holds, even counting one unit per claim line	63.8	69.9	46.6	68.8	449	2	90876 96132 96136 99211 99213 99214 99408	$241K
Apr 2024	More hours than a day holds, even counting one unit per claim line	65.5	69.8	46.5	63.5	455	3	90876 96132 96136 99211 99213 99214 99408	$240K
May 2024	More hours than a day holds, even counting one unit per claim line	62.6	68.4	45.6	61.5	489	3	90876 96132 96136 99211 99213 99214 99408	$240K
Jun 2024	More hours than a day holds, even counting one unit per claim line	63.1	69.0	46.0	69.0	446	3	90876 96132 96136 99211 99213 99214 99408	$233K
Jul 2024	More hours than a day holds, even counting one unit per claim line	83.5	79.6	53.1	64.3	506	4	90876 97032 97112 99211 99213 99214	$298K
Aug 2024	More hours than a day holds, even counting one unit per claim line	79.7	70.7	47.2	65.7	561	4	90876 97032 97112 99211 99213 99214 H0004	$272K
Sep 2024	More hours than a day holds, even counting one unit per claim line	56.5	48.1	32.0	45.8	431	3	90876 99213 99214 99408	$177K
Oct 2024	More hours than a day holds, even counting one unit per claim line	49.8	41.3	27.5	37.1	303	2	90876 99213 99214	$156K
Nov 2024	More hours than a day holds, even counting one unit per claim line	51.8	43.8	29.2	41.7	309	2	90876 99213 99214	$160K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	ROSALY MARIE DIAZ TORRUELLAS, M.D
Type	Individual
Status	Active
NPI issued	January 31, 2014, last updated November 22, 2022
Practice location	2801 W CHARLESTON BLVD STE 200, Las Vegas, NV 89102-1965, 702-659-9180
Specialties	Internal Medicine (207R00000X, license 17739 PR) Hospitalist (208M00000X, license 17739 NV) Internal Medicine (207R00000X, primary, license 17070 NV)

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
90876	Psychophysiological therapy with biofeedback 45 min	$3.1M	37%	$952	$392 (top 5% from $816)	99th percentile
95165	Professional service for preparation and provision of 1 or more antigens	$2.2M	26%	$2K	$187 (top 5% from $1K)	99th percentile
98960	Medicaid service code	$1.0M	12%	$444	$0.86 (top 5% from $182)	98th percentile
Q3014	Telehealth originating site facility fee	$777K	9%	$170	$21 (top 5% from $84)	98th percentile
95004	Test for allergy using allergenic extract	$354K	4%	$472	$136 (top 5% from $315)	99th percentile
90868	Treatment using magnetic field to stimulate nerve cells in brain, subsequent delivery and management	$238K	3%	$1K	$1K (top 5% from $2K)	46th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$238K	3%	$88	$44 (top 5% from $110)	91st percentile
99211	Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	$128K	2%	$84	$16 (top 5% from $128)	90th 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
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	320	142	$19K	$278	$76	3.7x	2.6x (90th percentile 4.3x)
99239	Hospital discharge day management, more than 30 minutes	117	115	$10K	$411	$110	3.7x	2.8x (90th percentile 5.6x)
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	118	57	$10K	$515	$125	4.1x	2.3x (90th percentile 3.8x)
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	90	44	$8K	$398	$114	3.5x	2.6x (90th percentile 4.7x)
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	40	40	$5K	$773	$167	4.6x	3.0x (90th percentile 5.6x)
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	44	43	$4K	$525	$126	4.2x	2.7x (90th percentile 4.4x)
99496	Transitional care management services for problem of high complexity	14	14	$3K	$1K	$273	4.0x	1.9x (90th percentile 3.1x)
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	48	33	$3K	$358	$88	4.1x	2.2x (90th percentile 3.8x)

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

338 providers in Clark County, NV carry an indicator in the public record, with $272.8M at stake between them. The most common is part of a provider network, on 167 of them, followed by more hours than a day holds on 151. 17 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	TIMOTHY WILSON Las Vegas, NV, ranked 113	$192K	Listed on the Medicare revocation list since January 26, 2023. Medicaid still paid claims in 21 later months, $191,872 in total.
1	DEVONTE' CHRISTOPHER North Las Vegas, NV, ranked 175	$59K	Listed on the AZ Medicaid exclusion list since September 1, 2024. Medicaid still paid claims in 1 later month, $59,101 in total.
1	MANE SHAH Las Vegas, NV, ranked 205	$40K	Listed on the Medicare revocation list since August 16, 2018. Medicaid still paid claims in 15 later months, $40,126 in total.
1	JOHN MARIUS TOLENTINO Las Vegas, NV, ranked 254	$16K	Listed on the CA Medicaid exclusion list since December 2, 2022. Medicaid still paid claims in 5 later months, $16,415 in total.
1	DAVID ADAMS Las Vegas, NV, ranked 345	$3K	Listed on the CA Medicaid exclusion list since October 2, 2018. Medicaid still paid claims in 2 later months, $3,216 in total.
1	VICTOR BRUCE Las Vegas, NV, ranked 361	$2K	Listed on the OIG exclusion list and the NY Medicaid exclusion list and the SAM.gov exclusion list (OPM) since December 20, 2015. Medicaid still paid claims in 2 later months, $2,266 in total.
1	AMARA MEDICAL CENTER LLC Las Vegas, NV, ranked 457	$9	Listed on the Medicare revocation list since June 20, 2024. Medicaid still paid claims in 2 later months, $9 in total.
1	RODNESHIA CARTER North Las Vegas, NV, ranked 479	$0	Adjudicated (sentenced) per a state attorney general release dated December 9, 2024. No Medicaid payments in the last 12 observed months.

All 338 in NV

Recent enforcement in NV

All releases

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

DOJIndictedSep 24, 2025

Reno Doctor Arrested And Indicted For Health Care Fraud

An OB-GYN allegedly submitted false claims to Medicaid and private health plans for gynecologic tests and surgical procedures that were not medically necessary and falsified patients' medical records.

DOJPleaded guiltyJul 16, 2025

Nevada Nurse Practitioner Pleads Guilty To Fraudulent Medicare Wound Care Billing

A nurse practitioner admitted conspiring to fraudulently bill Medicare approximately $14,333,550 for amniotic wound allografts that were medically unnecessary and were procured through illegal kickbacks and bribes.

DOJChargedJun 30, 2025

U.S. Attorney's Office Participates In Record-Setting National Health Care Fraud Takedown

Two Las Vegas nurses were charged by information with conspiracy to defraud the United States and to pay and receive kickbacks for applying medically unnecessary amniotic wound allografts to Medicare beneficiaries and receiving kickbacks, with wound care companies billing Medicare over $94 million and approximately $14.3 million respectively.

DOJSentencedMay 1, 2024

Las Vegas Woman Sentenced To Prison For $1 Million Medicaid Fraud Scheme

Binford failed to disclose her criminal history to enroll her company Shepherd's Heart Services as a Nevada Medicaid provider and then submitted false bills for counseling services and training not rendered.

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.

Ask this case

Answers come only from the evidence tables, and every sentence cites the record it used.