Providers
All 10 in CA
MATTHEW HADILAKSONO, DO
NPI 1205225174, individual, Templeton, CA, Physical Medicine & Rehabilitation
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 4 months, but with up to 1833 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99490 ($41 per patient-month) sit in the top 5% of every provider billing that code.
- Medicare submitted charges on code 95886 are 3.7 times the typical charge-to-allowed ratio for that code.
score 57 of 100, rank 7340, $447K 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 2019 | More hours than a day holds, even counting one unit per claim line | 29.7 | 32.3 | 21.5 | 20.2 | 1833 | 1 | 96138 99203 99204 99211 99213 99214 | $78K |
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 28.9 | 27.3 | 18.2 | 19.6 | 1801 | 1 | 96138 99203 99204 99211 99213 99214 | $76K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 27.0 | 22.4 | 15.0 | 18.0 | 1607 | 1 | 96138 99203 99204 99211 99213 99214 | $72K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 27.0 | 23.1 | 15.4 | 18.8 | 1616 | 1 | 96138 99203 99204 99211 99213 99214 | $67K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MATTHEW HADILAKSONO, DO |
| Type | Individual |
| Status | Active |
| NPI issued | January 15, 2015, last updated March 1, 2022 |
| Practice location | 1105 LAS TABLAS RD STE D, Templeton, CA 93465-9731, 805-550-6689 |
| Mailing address | 128 LA COLIMA, Pismo Beach, CA 93449-2841 |
| Specialties | Physical Medicine & Rehabilitation, Pain Medicine (2081P2900X, license 20A15470 CA) Physical Medicine & Rehabilitation (208100000X, primary, license 20A15470 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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.2M | 53% | $45 | $60 (top 5% from $133) | 30th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $173K | 8% | $30 | $44 (top 5% from $110) | 27th percentile | |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | $152K | 7% | $41 | $6.11 (top 5% from $38) | 95th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $125K | 6% | $84 | $95 (top 5% from $171) | 36th percentile | |
| 95886 | Needle measurement of electrical activity in arm or leg muscles, complete study | $84K | 4% | $53 | $81 (top 5% from $202) | 27th percentile | |
| 95913 | Nerve conduction, 13 or more studies | $55K | 3% | $146 | $189 (top 5% from $312) | 28th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $42K | 2% | $60 | $67 (top 5% from $121) | 39th percentile | |
| 96138 | Administration of psychological or neuropsychological test by technician, first 30 minutes | $36K | 2% | $18 | $22 (top 5% from $77) | 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 |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 1,406 | 426 | $145K | $1K | $137 | 7.3x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 1,028 | 332 | $75K | $800 | $98 | 8.2x | 2.2x (90th percentile 3.8x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 206 | 206 | $27K | $2K | $178 | 8.4x | 2.4x (90th percentile 3.9x) |
| 95886 | Needle measurement of electrical activity in arm or leg muscles, complete study | 201 | 112 | $17K | $1K | $108 | 11.2x | 3.0x (90th percentile 6.3x) |
| 95911 | Nerve conduction, 9-10 studies | 67 | 66 | $11K | $3K | $232 | 12.9x | 3.1x (90th percentile 6.8x) |
| 95913 | Nerve conduction, 13 or more studies | 39 | 39 | $9K | $5K | $313 | 16.0x | 3.1x (90th percentile 6.6x) |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 74 | 56 | $7K | $3K | $129 | 19.4x | 5.5x (90th percentile 16.3x) |
| 64635 | Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint | 40 | 23 | $6K | $3K | $201 | 14.9x | 5.2x (90th percentile 13.7x) |
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
10 providers in San Luis Obispo County, CA carry an indicator in the public record, with $16.6M at stake between them. The most common is more hours than a day holds, on 8 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | GUARDIAN ANGEL HOME CARE OF SAN LUIS OBISPO San Luis Obispo, CA, ranked 4192 | $0 |
|
| 3 | COMMUNITY HOME HEALTH INC Arroyo Grande, CA, ranked 6870 | $0 |
|
| 4 | SHAUNA LYNCH Atascadero, CA, ranked 7462 | $4.7M |
|
| 4 | WILLIAM MORGAN Arroyo Grande, CA, ranked 7546 | $3.2M |
|
| 4 | PEDRO GUIMARAES San Luis Obispo, CA, ranked 7565 | $3.0M |
|
| 4 | RICHARD ALTESMAN San Luis Obispo, CA, ranked 7592 | $2.7M |
|
| 4 | ABDELLATIF AICHOURI San Luis Obispo, CA, ranked 7899 | $682K |
|
| 4 | JOSE FELIBERTI Arroyo Grande, CA, ranked 7944 | $492K |
|
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.