BARBARA SUSAN LEVY, M.D.

NPI 1184629859, individual, La Jolla, CA, Obstetrics & Gynecology, Gynecology

Evidence tier

structure or single-organization volume

Hours beyond a day in 15 months, but with up to 716 patients a month across 10 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 99203 ($214 per patient-month) sit in the top 5% of every provider billing that code.

score 55 of 100, rank 7693, $1.9M 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
Feb 2021	More hours than a day holds at a conservative unit price	5.6	45.6	30.4	42.5	431	7	99203 99212 99213 99214	$59K
Mar 2021	More hours than a day holds at a conservative unit price	6.4	50.8	33.9	45.6	531	8	99203 99212 99213 99214	$76K
Apr 2021	More hours than a day holds at a conservative unit price	5.4	40.6	27.0	36.9	437	8	99203 99212 99213 99214	$57K
Jul 2021	More hours than a day holds at a conservative unit price	6.6	44.0	29.3	41.3	621	8	99202 99203 99211 99212 99213 99214	$66K
Aug 2021	More hours than a day holds at a conservative unit price	8.3	56.2	37.5	52.8	716	9	99202 99203 99211 99212 99213 99214	$93K
Sep 2021	More hours than a day holds at a conservative unit price	8.1	54.2	36.1	49.3	652	10	99202 99203 99204 99211 99212 99213 99214	$81K
Oct 2021	More hours than a day holds at a conservative unit price	7.4	52.3	34.9	51.5	669	10	99202 99203 99211 99212 99213 99214	$76K
Nov 2021	More hours than a day holds at a conservative unit price	7.4	47.6	31.8	43.3	590	9	99202 99203 99211 99212 99213 99214	$76K
Dec 2021	More hours than a day holds at a conservative unit price	6.7	39.3	26.2	35.3	556	8	99202 99203 99212 99213 99214	$64K
Feb 2022	More hours than a day holds at a conservative unit price	7.7	44.8	29.8	41.8	578	9	99202 99203 99204 99212 99213 99214	$62K
Mar 2022	More hours than a day holds at a conservative unit price	7.0	39.8	26.5	35.8	588	7	99202 99203 99211 99212 99213 99214	$64K
Aug 2022	More hours than a day holds at a conservative unit price	7.0	36.6	24.4	32.9	543	9	99202 99203 99212 99213 99214	$61K
Dec 2022	More hours than a day holds at a conservative unit price	7.2	40.9	27.3	38.4	562	8	99202 99203 99204 99212 99213 99214	$66K
Jan 2023	More hours than a day holds at a conservative unit price	7.7	50.9	33.9	47.8	641	6	99202 99203 99212 99213 99214	$73K
Feb 2023	More hours than a day holds at a conservative unit price	6.1	36.4	24.3	34.0	445	6	99202 99203 99212 99213 99214	$47K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	BARBARA SUSAN LEVY, M.D.
Type	Individual
Status	Active
NPI issued	June 17, 2005, last updated November 5, 2020
Practice location	1485 DEER HILL CT, La Jolla, CA 92037-7429, 253-740-7350
Specialties	Specialist (174400000X, license MD00019274 WA) Obstetrics & Gynecology, Gynecology (207VG0400X, primary, license G43461 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	$785K	25%	$94	$44 (top 5% from $110)	92nd percentile
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$614K	20%	$133	$60 (top 5% from $133)	95th percentile
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	$402K	13%	$214	$67 (top 5% from $121)	99th percentile
87806	Detection test by immunoassay with direct visual observation for hiv-1 antigen, with hiv-1 and hiv-2 antibodies	$337K	11%	$30	$25 (top 5% from $35)	81st percentile
S4993	Medicaid service code	$216K	7%	$116	$77 (top 5% from $195)	66th percentile
J3490	Unclassified drugs	$189K	6%	$52	$4.55 (top 5% from $108)	89th percentile
S0199	Medicaid service code	$175K	6%	$541	$439 (top 5% from $595)	88th percentile
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	$152K	5%	$58	$28 (top 5% from $147)	84th percentile

In this area

141 providers in San Diego County, CA carry an indicator in the public record, with $219.9M at stake between them. The most common is more hours than a day holds, on 82 of them, followed by part of a provider network on 43. 12 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	BRENTON WYNN National City, CA, ranked 19	$52K	Listed on the CA Medicaid exclusion list and the Medicare revocation list since May 23, 2022. Medicaid still paid claims in 6 later months, $51,770 in total. and 1 more
1	MICHAEL I KELLER M.D. INC San Diego, CA, ranked 124	$141K	Listed on the CA Medicaid exclusion list since December 10, 2020. Medicaid still paid claims in 18 later months, $141,240 in total.
1	BRENTON D. WYNN, MD INC National City, CA, ranked 135	$125K	Listed on the CA Medicaid exclusion list since May 23, 2022. Medicaid still paid claims in 27 later months, $125,367 in total.
1	BRUCE BAKER Poway, CA, ranked 144	$107K	Listed on the CA Medicaid exclusion list since July 13, 2020. Medicaid still paid claims in 3 later months, $106,617 in total.
1	KYUNG BOEN San Marcos, CA, ranked 191	$50K	Listed on the WA Medicaid exclusion list since April 7, 2017. Medicaid still paid claims in 16 later months, $50,384 in total.
1	ROOZBEH BADII San Diego, CA, ranked 199	$45K	Listed on the OIG exclusion list and the NY Medicaid exclusion list and the CA Medicaid exclusion list since February 15, 2018. Medicaid still paid claims in 15 later months, $44,839 in total.
1	CHIVANO CHHIENG San Diego, CA, ranked 231	$24K	Listed on the CA Medicaid exclusion list since July 14, 2020. Medicaid still paid claims in 12 later months, $23,669 in total.
1	JOHN QIAN San Diego, CA, ranked 232	$23K	Listed on the CA Medicaid exclusion list since February 11, 2022. Medicaid still paid claims in 5 later months, $23,392 in total. and 3 more

All 141 in CA

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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