MARINA NESTERENKO, M.D.
NPI 1346404118, individual, Sarasota, FL, Psychiatry & Neurology, Psychiatry
- Hours beyond a day in 3 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99223 ($278 per patient-month) sit in the top 5% of every provider billing that code.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 24.3 | 29.9 | 19.9 | 26.9 | 199 | 1 | 99223 99232 99233 99238 | $45K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 24.4 | 17.6 | 11.7 | 15.8 | 154 | 1 | 99223 99232 99233 99238 | $29K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 29.1 | 18.1 | 12.1 | 17.5 | 119 | 1 | 99223 99232 99233 99238 | $26K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MARINA NESTERENKO, M.D. (also MARYNA RUDZYNSKA) |
| Type | Individual |
| Status | Active |
| NPI issued | July 10, 2008, last updated September 29, 2014 |
| Practice location | 5682 BEE RIDGE RD, SUITE 100, Sarasota, FL 34233-1540, 941-371-3349 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 259220 NY) |
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 | |
|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $149K | 40% | $243 | $67 (top 5% from $174) | 98th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $119K | 32% | $278 | $81 (top 5% from $170) | 99th percentile | |
| 99238 | Hospital discharge day management, 30 minutes or less | $68K | 18% | $113 | $48 (top 5% from $80) | 99th percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $35K | 10% | $281 | $96 (top 5% from $249) | 97th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 458 | 128 | $24K | $104 | $69 | 1.5x | 2.1x (90th percentile 3.5x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 277 | 103 | $17K | $151 | $86 | 1.8x | 2.2x (90th percentile 3.8x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 162 | 67 | $15K | $179 | $120 | 1.5x | 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 | 50 | 50 | $6K | $254 | $163 | 1.6x | 2.4x (90th percentile 3.9x) |
| 90836 | Psychotherapy with evaluation and management visit, 45 minutes | 51 | 40 | $3K | $120 | $87 | 1.4x | 2.0x (90th percentile 3.2x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 27 | 27 | $2K | $200 | $109 | 1.8x | 2.4x (90th percentile 3.9x) |
| 90785 | Psychiatric services complicated by communication factor | 37 | 16 | $407 | $31 | $14 | 2.2x | 2.4x (90th percentile 7.3x) |
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
8 providers in Sarasota County, FL carry an indicator in the public record, with $4.7M at stake between them. The most common is part of a provider network, on 4 of them, followed by more hours than a day holds on 3.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | TIDEWELL HOSPICE, INC. Sarasota, FL, ranked 926 | $4.5M |
|
| 3 | CONTINUUM CARE OF SARASOTA LLC Sarasota, FL, ranked 1360 | $97K |
|
| 3 | ALLPRO HOME HEALTH, LLC Osprey, FL, ranked 4622 | $0 |
|
| 3 | MHC AREA 8, LLC Venice, FL, ranked 5055 | $0 |
|
| 3 | NEW LEVEL 3 Sarasota, FL, ranked 6607 | $0 |
|
| 4 | ROBINDER BHANGOO Sarasota, FL, ranked 9696 | $25K |
|
| 5 | TARIQ HALIM Lakewood Ranch, FL, ranked 10484 | $69K |
|
| 5 | STEPHEN DUCKER North Venice, FL, ranked 11921 | $13K |
Recent enforcement in FL
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.