SEPEHR KATIRAIE, M.D.

NPI 1225084213, individual, Huntington Park, CA, Family Medicine

Evidence tier

informational

Medicaid dollars per patient on code 99203 ($279 per patient-month) sit in the top 5% of every provider billing that code.

score 35 of 100, rank 10211, $625K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	SEPEHR KATIRAIE, M.D.
Type	Individual, sole proprietor
Status	Active
NPI issued	May 25, 2006, last updated November 15, 2024
Practice location	2638 E FLORENCE AVE, Huntington Park, CA 90255-4708, 323-588-3800
Mailing address	724 N ELM DR, Beverly Hills, CA 90210-3423
Specialties	Family Medicine (207Q00000X, primary, license A54478 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
99202	New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more	$296K	18%	$181	$45 (top 5% from $138)	97th percentile
99203	New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	$242K	15%	$279	$67 (top 5% from $121)	100th percentile
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	$238K	15%	$75	$28 (top 5% from $147)	88th percentile
Z1034	Medicaid service code	$228K	14%	$100	$0.00 (top 5% from $88)	99th percentile
Z1032	Medicaid service code	$131K	8%	$163	$0.00 (top 5% from $160)	97th percentile
Z6500	Medicaid service code	$108K	7%	$124	$123 (top 5% from $125)	71st percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$97K	6%	$34	$44 (top 5% from $110)	34th percentile
Z6304	Medicaid service code	$37K	2%	$32	$0.00 (top 5% from $18)	99th 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	331	79	$32K	$349	$138	2.5x	2.3x (90th percentile 3.8x)
17004	Destruction of precancer skin growth, 15 or more growths	36	32	$5K	$443	$184	2.4x	2.3x (90th percentile 4.0x)
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	29	29	$4K	$375	$180	2.1x	2.4x (90th percentile 3.9x)
G0438	Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	11	11	$2K	$500	$178	2.8x	2.3x (90th percentile 4.2x)
17003	Destruction of precancer skin growth, 2-14 growths	234	13	$1K	$17	$8	2.3x	3.0x (90th percentile 9.4x)
G0442	Annual alcohol misuse screening, 5 to 15 minutes	32	32	$675	$150	$21	7.1x	2.2x (90th percentile 3.8x)
17000	Destruction of precancer skin growth, 1 growth	18	13	$235	$25	$25	1.0x	3.0x (90th percentile 5.4x)
36415	Insertion of needle into vein for collection of blood sample	25	25	$216	$50	$9	5.8x	2.0x (90th percentile 3.5x)

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

400 providers in Los Angeles County, CA carry an indicator in the public record, with $129.6M at stake between them. The most common is part of a provider network, on 347 of them, followed by paid after a public list action on 37. 53 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	BURBANK PREFERRED PROVIDER MEDICAL GROUP, INC Burbank, CA, ranked 17	$67K	Listed on the Medicare revocation list since October 21, 2020. Medicaid still paid claims in 24 later months, $67,101 in total. and 1 more
1	GOLDEN STAR LABS LLC Los Angeles, CA, ranked 32	$41.0M	Adjudicated (pleaded guilty) per a Department of Justice release dated June 24, 2026. Medicaid paid $41,015,276 in the last 12 observed months.
1	MATIAS CLINICAL LABORATORY INC Baldwin Park, CA, ranked 43	$3.8M	Listed on the Medicare revocation list since August 31, 2018. Medicaid still paid claims in 44 later months, $3,846,471 in total. and 1 more
1	HEALTHSMART PACIFIC INC Long Beach, CA, ranked 52	$1.6M	Listed on the OIG exclusion list since April 20, 2021. Medicaid still paid claims in 34 later months, $1,639,221 in total.
1	LINDA WARREN-WATSON Lancaster, CA, ranked 71	$828K	Listed on the CA Medicaid exclusion list since October 31, 2020. Medicaid still paid claims in 16 later months, $828,250 in total.
1	SOHRAB MOSHIRI Woodland Hills, CA, ranked 82	$483K	Listed on the WA Medicaid exclusion list since January 9, 2009. Medicaid still paid claims in 83 later months, $482,999 in total.
1	QUALITY FAMILY HOSPICE CARE INC Tarzana, CA, ranked 92	$375K	Listed on the CA Medicaid exclusion list and the Medicare revocation list since July 18, 2024. Medicaid still paid claims in 4 later months, $375,479 in total.
1	MARATHON HOSPICE CARE INC. North Hollywood, CA, ranked 95	$368K	Listed on the Medicare revocation list since July 6, 2024. Medicaid still paid claims in 4 later months, $367,866 in total.

All 400 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

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.