JANE-FRANCES SHITI, FNP-C
NPI 1215461629, individual, Rio Rancho, NM, Nurse Practitioner, Family
- Medicaid dollars per patient on code 99309 ($151 per patient-month) sit in the top 5% of every provider billing that code.
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JANE-FRANCES SHITI, FNP-C |
| Type | Individual |
| Status | Active |
| NPI issued | April 13, 2017, last updated December 8, 2021 |
| Practice location | 3550 BUCKSKIN LOOP NE, Rio Rancho, NM 87144-1446, 505-316-5984 |
| Specialties | Nurse Practitioner, Family (363LF0000X, license AP133605 TX) Nurse Practitioner, Family (363LF0000X, primary, license 57160 NM) |
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.
| 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 | $399K | 75% | $107 | $21 (top 5% from $84) | 97th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $75K | 14% | $151 | $60 (top 5% from $133) | 97th percentile | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $31K | 6% | $212 | $88 (top 5% from $210) | 95th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $14K | 3% | $32 | $14 (top 5% from $58) | 85th percentile | |
| 99205 | New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | $9K | 2% | $174 | $128 (top 5% from $249) | too few months to rank | |
| 99318 | Medicaid service code | $2K | 0% | $45 | $18 (top 5% from $58) | too few months to rank | |
| 3288F | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $0.00) | too few months to rank | |
| G8427 | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $0.08) | 0th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 90 | 59 | $2K | $133 | $86 | 1.5x | 2.0x (90th percentile 3.3x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 23 | 13 | $2K | $207 | $103 | 2.0x | 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
2 providers in Sandoval County, NM carry an indicator in the public record, with $5.3M at stake between them. The most common is more hours than a day holds, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | ROBBEN GINGERY Rio Rancho, NM, ranked 7476 | $4.5M |
|
| 4 | WENDEE BURNETT Rio Rancho, NM, ranked 7881 | $772K |
|
Recent enforcement in NM
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
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.