Providers
AMR HOSSAM ELDIN BEHIRI, DO
NPI 1154588580, individual, Ashburn, VA, Internal Medicine
5
Evidence tier
informational
score 30 of 100, rank 11471, $194K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | AMR HOSSAM ELDIN BEHIRI, DO |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | May 22, 2008, last updated June 14, 2021 |
| Practice location | 41816 FENWAY CIR, Ashburn, VA 20148-8069, 347-761-7200 |
| Specialties | Internal Medicine (207R00000X, license H00091853 MD) Internal Medicine (207R00000X, primary, license 0102202559 VA) |
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 | |
|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $260K | 54% | $47 | $21 (top 5% from $84) | 85th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $150K | 31% | $32 | $14 (top 5% from $58) | 85th percentile | |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | $53K | 11% | $45 | $30 (top 5% from $134) | 68th percentile | |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | $8K | 2% | $45 | $37 (top 5% from $100) | 63rd percentile | |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | $6K | 1% | $19 | $22 (top 5% from $71) | 41st percentile | |
| 99316 | Nursing facility discharge management, more than 30 minutes | $4K | 1% | $28 | $38 (top 5% from $83) | 37th percentile | |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | $2K | 0% | $18 | $7.86 (top 5% from $34) | 84th percentile | |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | $640 | 0% | $5.82 | $7.66 (top 5% from $22) | 41st 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 |
|---|---|---|---|---|---|---|---|---|
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a | 237 | 175 | $8K | $72 | $45 | 1.6x | 2.1x (90th percentile 3.3x) |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 142 | 138 | $6K | $90 | $57 | 1.6x | 2.3x (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
3 providers in Loudoun County, VA carry an indicator in the public record, with $1.3M at stake between them. The most common is paid after a public list action, on 1 of them, followed by part of a provider network on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | STONESPRINGS GASTROENTEROLOGY PLLC Dulles, VA, ranked 264 | $14K |
|
| 3 | CCSP NOVA LLC Sterling, VA, ranked 2963 | $0 |
|
| 5 | ZAHRA HUSSAIN Leesburg, VA, ranked 10061 | $1.3M |
|
Recent enforcement in VA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
U.S. Attorney’s Office announces charges against three defendants in the Eastern District of Virginia as part of national health care fraud takedown
Three defendants were charged with fraudulently billing Medicaid for mental health services that were not provided and with submitting false claims to Medicare through a straw-owned durable medical equipment company.
DOJSentencedJun 5, 2026
Medicaid service providers sentenced for false statements resulting in overbilling
Wright and Winfield instructed CCR employees to falsely claim in progress notes that children received therapeutic day treatment services from 2:00pm to 7:00pm, including providing prefilled progress note templates, resulting in overbilling to Medicaid.
DOJCivil settlementApr 27, 2026
Tri-Area Community Health Agrees to Pay $513,000 to Resolve Medicare Billing Allegations
Tri-Area Community Health billed Medicare for Annual Wellness Visits provided by pharmacists without appropriate physician supervision that were billed under the names of physicians not involved with the visits.
DOJSentencedMar 17, 2026
Six Sentenced in Healthcare Fraud Conspiracy that Stole $10 Million from Medicaid Over Six-Year Period
Six defendants conspired to submit false claims to Virginia Medicaid on behalf of 1st Adult N Pediatric Healthcare Services for nursing and personal care services that were not provided, including falsifying records and paying parents or guardians of patients for blank, signed nursing notes.
DOJIndictedMar 11, 2026
Victim Advisory- Divine Youth Case Updates
Divine Youth Counseling submitted more than $11 million in fraudulent Medicaid claims for Crisis Stabilization and Mobile Crisis services by falsely claiming two mental health professionals provided Team Treatment services and paid more than $470,000 in kickbacks in the form of hotel rooms for Medicaid recipients.
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.