Providers
All 152 in VA
L5 MEDICAL HOLDINGS LLC
NPI 1336491877, organization, Madison Heights, VA, Anesthesiology, Pain Medicine
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since July 26, 2023.
- Medicaid still paid claims in 1 later month, $3,442 in total.
- Adjudicated (sentenced) per a state attorney general release and a Department of Justice release dated March 21, 2024.
score 94 of 100, rank 340, $3K at stake
Public list actions
Medicare revocation effective July 26, 2023, barred from re-enrolling until July 26, 2033
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Part B Supplier - Clinic/Group Practice, VA
Medicare revocation effective July 26, 2023, barred from re-enrolling until July 26, 2033
424.535(a)(3) felonies, Part B Supplier - Independent Clinical Laboratory, VA
OIG exclusion April 20, 2026 under section 1128a1
Other Business, Substance Abuse Reha, Mount Pleasant, SC
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| Medicare revocation list 424.535(a)(3) felonies | Exact NPI, name verified | Jul 26, 2023 | Jul 26, 2033 | 1 | Aug 2023 | Aug 2023 | $3K | $1.1M |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | L5 MEDICAL HOLDINGS LLC (also PAIN CARE CENTER; PAIN CARE CENTER OF LYNCHBURG) |
| Type | Organization |
| Status | Active |
| NPI issued | October 8, 2012, last updated September 20, 2019 |
| Practice location | 4262 S AMHERST HWY STE 200, Madison Heights, VA 24572-5363, 434-528-4640 |
| Mailing address | 10 RESOLUTE LN STE 200, Mount Pleasant, SC 29464-6608 |
| Authorized official | JOHN BARNES (President) |
| Specialties | Anesthesiology, Pain Medicine (207LP2900X, primary) |
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 | |
|---|---|---|---|---|---|---|---|
| G0483 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $1.6M | 44% | $161 | $146 (top 5% from $318) | too few months to rank | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.2M | 34% | $54 | $60 (top 5% from $133) | too few months to rank | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $391K | 11% | $56 | $45 (top 5% from $110) | too few months to rank | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $243K | 7% | $38 | $44 (top 5% from $110) | too few months to rank | |
| 99205 | New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more | $32K | 1% | $79 | $128 (top 5% from $249) | too few months to rank | |
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse | $29K | 1% | $54 | $88 (top 5% from $210) | too few months to rank | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $21K | 1% | $22 | $28 (top 5% from $147) | too few months to rank | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $17K | 0% | $87 | $95 (top 5% from $171) | too few months to rank |
In this area
152 providers in VA carry an indicator in the public record, with $101.7M at stake between them. The most common is part of a provider network, on 67 of them, followed by more hours than a day holds on 47. 21 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | MOHAMMAD HOQUE Arlington, VA, ranked 9 | $241K |
|
| 1 | SWIFT MEDICAL TRANSPORT LLC Virginia Beach, VA, ranked 14 | $140K |
|
| 1 | ADVANCED SPINE AND PAIN CENTERS, PLLC Stafford, VA, ranked 58 | $1.3M |
|
| 1 | SYNERGY HEALTH SYSTEMS Chesapeake, VA, ranked 80 | $510K |
|
| 1 | SALMAN AKBAR Richmond, VA, ranked 81 | $484K |
|
| 1 | RICHARD HILL Chesapeake, VA, ranked 88 | $407K |
|
| 1 | THOMAS RALEY Stafford, VA, ranked 104 | $253K |
|
| 1 | WASHINGTON GASTROENTEROLOGY PC Arlington, VA, ranked 110 | $228K |
|
Recent enforcement in VA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
U.S. Attorney’s Office announces charges against three defendants in the Eastern District of Virginia as part of national health care fraud takedown
Three defendants were charged with fraudulently billing Medicaid for mental health services that were not provided and with submitting false claims to Medicare through a straw-owned durable medical equipment company.
DOJSentencedJun 5, 2026
Medicaid service providers sentenced for false statements resulting in overbilling
Wright and Winfield instructed CCR employees to falsely claim in progress notes that children received therapeutic day treatment services from 2:00pm to 7:00pm, including providing prefilled progress note templates, resulting in overbilling to Medicaid.
DOJCivil settlementApr 27, 2026
Tri-Area Community Health Agrees to Pay $513,000 to Resolve Medicare Billing Allegations
Tri-Area Community Health billed Medicare for Annual Wellness Visits provided by pharmacists without appropriate physician supervision that were billed under the names of physicians not involved with the visits.
DOJSentencedMar 17, 2026
Six Sentenced in Healthcare Fraud Conspiracy that Stole $10 Million from Medicaid Over Six-Year Period
Six defendants conspired to submit false claims to Virginia Medicaid on behalf of 1st Adult N Pediatric Healthcare Services for nursing and personal care services that were not provided, including falsifying records and paying parents or guardians of patients for blank, signed nursing notes.
DOJIndictedMar 11, 2026
Victim Advisory- Divine Youth Case Updates
Divine Youth Counseling submitted more than $11 million in fraudulent Medicaid claims for Crisis Stabilization and Mobile Crisis services by falsely claiming two mental health professionals provided Team Treatment services and paid more than $470,000 in kickbacks in the form of hotel rooms for Medicaid recipients.
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.