Providers
RITU RASTOGI, MD
NPI 1366438822, individual, Wilmington, DE, Internal Medicine
2
Evidence tier
impossible volume with concurrency
- Billed more hands-on hours than a day holds in 3 months, peaking at 10.3 hours per day across 6 billing organizations.
score 81 of 100, rank 744, $316K 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 |
|---|---|---|---|---|---|---|---|---|---|
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 26.8 | 11.9 | 7.9 | 10.5 | 246 | 5 | 97110 97112 97140 97530 97535 | $37K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 25.9 | 12.4 | 8.2 | 12.1 | 253 | 6 | 97110 97140 97530 97535 | $41K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 28.9 | 16.2 | 10.8 | 13.9 | 290 | 6 | 97110 97116 97140 97530 97535 | $45K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RITU RASTOGI, MD |
| Type | Individual |
| Status | Active |
| NPI issued | September 21, 2005, last updated February 6, 2018 |
| Practice location | 1601 MILLTOWN RD, SUITE 2, Wilmington, DE 19808-4027, 302-543-6165 |
| Specialties | Internal Medicine (207R00000X, primary, license C1-0006452 DE) |
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 | |
|---|---|---|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | $514K | 52% | $286 | $76 (top 5% from $314) | 94th percentile | |
| 97530 | Therapy procedure using functional activities | $415K | 42% | $125 | $124 (top 5% from $387) | 50th percentile | |
| 97140 | Therapy procedure using manual technique, each 15 minutes | $27K | 3% | $119 | $47 (top 5% from $120) | 95th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $12K | 1% | $75 | $32 (top 5% from $49) | 100th percentile | |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | $7K | 1% | $59 | $59 (top 5% from $187) | 49th percentile | |
| 97116 | Therapy procedure for walking training, each 15 minutes | $4K | 0% | $139 | $30 (top 5% from $180) | too few months to rank | |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | $2K | 0% | $6.23 | $37 (top 5% from $100) | 4th percentile | |
| 97535 | Training for self-care or home management, each 15 minutes | $2K | 0% | $8.45 | $48 (top 5% from $459) | 14th 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 |
|---|---|---|---|---|---|---|---|---|
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 2,028 | 1,662 | $282K | $190 | $177 | 1.1x | 1.9x (90th percentile 3.1x) |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 3,308 | 1,332 | $265K | $112 | $105 | 1.1x | 2.0x (90th percentile 3.3x) |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 285 | 215 | $34K | $160 | $150 | 1.1x | 2.0x (90th percentile 3.4x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 164 | 164 | $21K | $150 | $127 | 1.2x | 2.3x (90th percentile 4.1x) |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 89 | 84 | $9K | $140 | $130 | 1.1x | 2.0x (90th percentile 3.3x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 134 | 104 | $8K | $100 | $73 | 1.4x | 2.0x (90th percentile 3.4x) |
| G0179 | Physician or allowed practitioner re-certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians a | 209 | 204 | $6K | $100 | $41 | 2.4x | 2.1x (90th percentile 3.3x) |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 94 | 48 | $5K | $80 | $62 | 1.3x | 1.8x (90th percentile 2.9x) |
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
7 providers in New Castle County, DE carry an indicator in the public record, with $9.1M at stake between them. The most common is more hours than a day holds, on 4 of them, followed by paid after a public list action on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | SHAYASTA MUFTI Bear, DE, ranked 5349 | $0 |
|
| 4 | QAYYUM NAZAR Bear, DE, ranked 8019 | $227K |
|
| 4 | NIEEMA MAHDI Wilmington, DE, ranked 8390 | $55K |
|
| 4 | MELISSA SCHNECK Wilmington, DE, ranked 9765 | $3K |
|
| 4 | MALIKA MCMEANS SPRUILL Townsend, DE, ranked 9776 | $617 |
|
| 5 | MEDICAL ONCOLOGY HEMATOLOGY CONSULTANTS PA Newark, DE, ranked 10669 | $8.8M | |
| 5 | BIOTEK REMEDYS, INC. New Castle, DE, ranked 11792 | $41K |
Recent enforcement in DE
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyJul 2, 2026
South Dakota Man Pleads Guilty to Aggravated Identity Theft and Obtaining Drugs by Fraud
Mauldin used his access as a medical biller and credentialer to steal medical professionals' licensure information to order thousands of opioid pills, falsified his own electronic medical records to pose as a cancer patient and obtain pain management services paid by his private health insurer, and held himself out as a licensed nurse to perform Transcranial Magnetic Stimulation therapy and submit false claims to Medicaid.
DOJComplaint filedJun 30, 2026
Civil Complaint Filed Over False Laboratory Claims
The United States alleges the defendants violated the False Claims Act by submitting thousands of claims to government health care programs for laboratory diagnostic tests that lacked a valid medical purpose, were conducted in violation of laboratory clinical standards, and in numerous cases were not conducted at all.
DOJCivil settlementApr 29, 2026
Former Delaware Physician to Pay $180,000 to Resolve Allegations of Genetic Testing Fraud
A physician agreed to pay $180,000 to resolve False Claims Act allegations that she ordered medically unnecessary genetic tests for more than 100 Medicare beneficiaries with whom she had no established physician-patient relationship, often based only on brief telemedicine consultations or none at all.
DOJIndictedDec 15, 2025
Medical Biller Charged with Diverting Opioids and Federal Health Care Fraud
A medical biller and credentialer used stolen identities and licensure information of medical professionals to order and prescribe himself thousands of opioid pills, falsified his own medical records to obtain pain management treatment paid by a private insurer, and submitted false claims to Medicaid for Transcranial Magnetic Stimulation therapy he performed while posing as a nurse.
DOJComplaint filedJul 7, 2025
United States Files False Claim Act Complaint Against Delaware Medical Provider
The United States alleges that Dr. Mufti referred more than 100 Medicare beneficiaries for medically unnecessary genetic laboratory tests based on brief telemedicine consultations or no consultation, causing false claims to Medicare.
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.