KRISHNA PRASAD MADIRAJU, M.D.FAAP
NPI 1376600759, individual, Woodbridge, VA, Pediatrics
- Hours beyond a day in 8 months, but with up to 1744 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
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 |
|---|---|---|---|---|---|---|---|---|---|
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 27.1 | 41.4 | 27.6 | 37.7 | 1592 | 1 | 99212 99213 99214 | $140K |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 24.4 | 37.1 | 24.7 | 36.5 | 1419 | 1 | 99203 99211 99212 99213 99214 | $130K |
| May 2022 | More hours than a day holds at a conservative unit price | 23.3 | 36.3 | 24.2 | 34.1 | 1425 | 1 | 99212 99213 99214 | $126K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 26.0 | 42.9 | 28.6 | 39.0 | 1570 | 1 | 99203 99212 99213 99214 | $144K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 28.2 | 47.8 | 31.9 | 47.1 | 1744 | 1 | 99212 99213 99214 | $166K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 25.7 | 43.7 | 29.1 | 39.7 | 1647 | 1 | 99202 99212 99213 99214 | $147K |
| Oct 2023 | More hours than a day holds at a conservative unit price | 23.4 | 38.6 | 25.7 | 36.3 | 1479 | 1 | 99212 99213 99214 | $135K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 24.4 | 40.9 | 27.3 | 37.2 | 1535 | 1 | 99203 99212 99213 99214 | $138K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | KRISHNA PRASAD MADIRAJU, M.D.FAAP |
| Type | Individual |
| Status | Active |
| NPI issued | January 3, 2007, last updated November 7, 2012 |
| Practice location | 2024 OPITZ BLVD STE A, Woodbridge, VA 22191-3388, 703-492-7000 |
| Mailing address | 22445 CONSERVANCY DR, Ashburn, VA 20148-8068 |
| Specialties | Pediatrics (208000000X, primary, license 0101054958 VA) |
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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $3.7M | 34% | $101 | $60 (top 5% from $133) | 86th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $3.0M | 27% | $74 | $44 (top 5% from $110) | 85th percentile | |
| 99392 | Medicaid service code | $675K | 6% | $79 | $78 (top 5% from $124) | 51st percentile | |
| 99393 | Medicaid service code | $618K | 6% | $77 | $78 (top 5% from $121) | 49th percentile | |
| 99391 | Medicaid service code | $505K | 5% | $74 | $76 (top 5% from $126) | 47th percentile | |
| 99394 | Medicaid service code | $487K | 4% | $83 | $83 (top 5% from $128) | 50th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $291K | 3% | $39 | $28 (top 5% from $147) | 70th percentile | |
| 90649 | Medicaid service code | $260K | 2% | $80 | $1.16 (top 5% from $41) | 98th percentile |
In this area
5 providers in Prince William County, VA carry an indicator in the public record, with $216K at stake between them. The most common is part of a provider network, on 2 of them, followed by paid after a public list action on 1. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | KAREN HOBBS Woodbridge, VA, ranked 281 | $11K |
|
| 1 | KYNETIC MEDICAL GROUP INC Woodbridge, VA, ranked 482 | $0 |
|
| 3 | HERITAGE HUNT LLC Gainesville, VA, ranked 3269 | $0 |
|
| 3 | MANASSAS HEALTH CARE LLC Manassas, VA, ranked 4147 | $0 |
|
| 5 | ALYSE MUNOZ Triangle, VA, ranked 10635 | $206K |
|
Recent enforcement in VA
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.