Providers
MUHAMMED ARIF NIAZ, M.D.
NPI 1255338869, individual, Elkton, MD, Internal Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 12 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99214 ($134 per patient-month) sit in the top 5% of every provider billing that code.
score 54 of 100, rank 7997, $294K 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds at a conservative unit price | 3.2 | 52.0 | 34.7 | 46.7 | 161 | 1 | 99213 99214 | $22K |
| Feb 2018 | More hours than a day holds at a conservative unit price | 2.7 | 44.1 | 29.4 | 41.1 | 119 | 1 | 99213 99214 | $16K |
| Mar 2018 | More hours than a day holds at a conservative unit price | 2.9 | 47.6 | 31.8 | 44.8 | 135 | 1 | 99213 99214 | $20K |
| Apr 2018 | More hours than a day holds at a conservative unit price | 2.5 | 38.5 | 25.7 | 36.7 | 120 | 1 | 99213 99214 | $15K |
| May 2018 | More hours than a day holds at a conservative unit price | 4.0 | 62.6 | 41.8 | 56.3 | 182 | 1 | 99213 99214 | $26K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 4.4 | 71.4 | 47.6 | 68.0 | 175 | 1 | 99213 99214 | $28K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 4.6 | 74.5 | 49.7 | 70.0 | 186 | 1 | 99213 99214 | $31K |
| Aug 2018 | More hours than a day holds at a conservative unit price | 4.6 | 75.4 | 50.3 | 67.8 | 178 | 1 | 99213 99214 | $31K |
| Sep 2018 | More hours than a day holds at a conservative unit price | 4.4 | 69.3 | 46.2 | 69.3 | 193 | 1 | 99213 99214 | $29K |
| Oct 2018 | More hours than a day holds at a conservative unit price | 4.1 | 63.4 | 42.2 | 56.9 | 185 | 1 | 99213 99214 | $27K |
| Nov 2018 | More hours than a day holds at a conservative unit price | 4.7 | 74.5 | 49.7 | 67.7 | 202 | 1 | 99213 99214 | $31K |
| Dec 2018 | More hours than a day holds at a conservative unit price | 2.6 | 41.0 | 27.3 | 40.3 | 150 | 1 | 99213 99214 | $17K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MUHAMMED ARIF NIAZ, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | June 29, 2005, last updated February 13, 2013 |
| Practice location | 107 N BRIDGE ST, Elkton, MD 21921-5326, 410-392-6408 |
| Mailing address | 18 BLACKBIRD CT, Newark, DE 19702-8625 |
| Specialties | Internal Medicine (207R00000X, primary, license D0059501 MD) |
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 | $910K | 47% | $134 | $60 (top 5% from $133) | 95th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $525K | 27% | $107 | $44 (top 5% from $110) | 95th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $405K | 21% | $87 | $45 (top 5% from $110) | 89th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $79K | 4% | $134 | $95 (top 5% from $171) | 81st percentile | |
| 80305 | Testing for presence of drug, read by direct observation | $9K | 0% | $16 | $9.23 (top 5% from $22) | 89th percentile | |
| 99407 | Smoking and tobacco use intensive counseling, more than 10 minutes | $6K | 0% | $25 | $14 (top 5% from $36) | 85th percentile | |
| 99406 | Smoking and tobacco use intensive counseling, 4-10 minutes | $2K | 0% | $10 | $7.24 (top 5% from $18) | 74th percentile | |
| 96372 | Injection of drug or substance under skin or into muscle | $2K | 0% | $12 | $12 (top 5% from $49) | 52nd 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 | 185 | 95 | $16K | $200 | $127 | 1.6x | 2.3x (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 | 100 | 100 | $12K | $356 | $167 | 2.1x | 2.4x (90th percentile 3.9x) |
| 95810 | Sleep study in sleep lab (6 years or older) | 50 | 49 | $5K | $261 | $114 | 2.3x | 3.4x (90th percentile 8.4x) |
| 95811 | Sleep study in sleep lab with continuous airway pressure (6 years or older) | 41 | 40 | $4K | $271 | $118 | 2.3x | 3.4x (90th percentile 8.7x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 51 | 37 | $3K | $150 | $90 | 1.7x | 2.2x (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 Cecil County, MD carry an indicator in the public record, with $2.6M at stake between them. The most common is more hours than a day holds, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | CORAZON SANCHEZ Port Deposit, MD, ranked 8620 | $2.6M |
|
| 4 | JOHN THOMAS Rising Sun, MD, ranked 9753 | $6K |
|
Recent enforcement in MD
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementMar 20, 2026
Health Care Management Corporation Agrees to Pay $4 Million to Resolve False Claims Act Allegations
CVR knowingly submitted claims to Medicare, Medicaid, and TRICARE for sclerotherapy, radiofrequency ablation, and endovenous laser ablation procedures to treat chronic venous insufficiency that were not clinically indicated and were medically unnecessary between January 1, 2010, and December 31, 2016.
DOJCivil settlementNov 20, 2025
Diagnostic Laboratory Agrees to Pay More Than $1 Million to Settle Alleged False Claims Act Violations
GTI agreed to pay $1.635 million to resolve allegations that it submitted Medicare claims for respiratory pathogen panels that were medically unnecessary or obtained through kickbacks paid under a marketing services agreement with an infection prevention company for laboratory test referrals from long-term care facilities.
DOJSentencedNov 13, 2025
Baltimore County Woman Sentenced for Impersonating Nurses and Aggravated Identity Theft
Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland that billed health care benefit programs including Medicare and Medicaid for services she provided, earning more than $145,000 in wages.
DOJPleaded guiltyAug 14, 2025
Baltimore County Woman Admits to Impersonating Nurses, Pleads Guilty to Aggravated Identity Theft
Amponsah used stolen nursing licenses and false educational and professional histories to obtain employment as a purported licensed nurse at no less than 40 facilities in Maryland, which billed health care benefit programs including Medicare and Medicaid for services she provided.
DOJCivil judgmentAug 11, 2025
United States Obtains More Than $1.4 Million Judgment Against Family Medical Practitioner for Fraudulent Billing
Akoto billed Medicare for auricular stimulation (P-Stim) devices using a code for a surgically implanted neurostimulator device, which Medicare does not reimburse as acupuncture.
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.