Providers
PA SOUA XIONG, M.D.
NPI 1386015220, individual, Grass Valley, CA, Family Medicine
5
Evidence tier
informational
score 30 of 100, rank 11447, $220K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PA SOUA XIONG, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | October 19, 2015, last updated April 4, 2025 |
| Practice location | 402 S AUBURN ST, Grass Valley, CA 95945-7226, 530-273-2221 |
| Specialties | Family Medicine (207Q00000X, primary, license 138627 CA) Family Medicine, Adult Medicine (207QA0505X, license A138627 CA) |
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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $116K | 16% | $77 | $44 (top 5% from $110) | 87th percentile | |
| 87491 | Detection test by nucleic acid for chlamydia trachomatis, amplified probe technique | $109K | 16% | $25 | $27 (top 5% from $50) | 45th percentile | |
| 87591 | Detection test by nucleic acid for neisseria gonorrhoeae (gonorrhoeae bacteria), amplified probe technique | $98K | 14% | $22 | $26 (top 5% from $46) | 41st percentile | |
| S4993 | Medicaid service code | $52K | 7% | $113 | $77 (top 5% from $195) | 64th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $48K | 7% | $115 | $45 (top 5% from $138) | 93rd percentile | |
| J3490 | Unclassified drugs | $46K | 7% | $24 | $4.55 (top 5% from $108) | 79th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $42K | 6% | $63 | $28 (top 5% from $147) | 86th percentile | |
| 99211 | Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional | $38K | 5% | $37 | $16 (top 5% from $128) | 79th 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 |
|---|---|---|---|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more | 369 | 155 | $48K | $198 | $189 | 1.0x | 2.4x (90th percentile 4.1x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 332 | 153 | $34K | $135 | $135 | 1.0x | 2.3x (90th percentile 3.8x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 138 | 138 | $19K | $143 | $139 | 1.0x | 2.3x (90th percentile 4.1x) |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | 49 | 49 | $14K | $313 | $291 | 1.1x | 1.1x (90th percentile 2.6x) |
| 90662 | Influenza vaccine split virus, preservative free | 77 | 75 | $6K | $80 | $78 | 1.0x | 1.1x (90th percentile 2.1x) |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's | 372 | 148 | $5K | $85 | $17 | 5.0x | 2.7x (90th percentile 4.5x) |
| G0444 | Annual depression screening, 5 to 15 minutes | 128 | 128 | $3K | $25 | $21 | 1.2x | 2.2x (90th percentile 3.8x) |
| G0008 | Administration of influenza virus vaccine | 79 | 77 | $3K | $35 | $33 | 1.1x | 1.2x (90th percentile 2.3x) |
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
2 providers in Nevada County, CA carry an indicator in the public record, with $0 at stake between them. The most common is part of a provider network, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | EDELWEISS HOLDINGS, LLC Grass Valley, CA, ranked 5600 | $0 |
|
| 3 | HOSPICE OF THE FOOTHILLS Grass Valley, CA, ranked 6068 | $0 |
|
Recent enforcement in CA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 27, 2026
Anaheim Woman Pleads Guilty to Submitting More Than $2.2 Million in Fraudulent Hospice Care Claims to Medicare
Galbraith submitted approximately $2,266,694 in claims to Medicare for hospice services for beneficiaries who did not have a terminal illness with a life expectancy of six months or less, and Medicare paid her company approximately $2,140,606.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. submitted claims to Medicare for skin cancer tests conducted with an unvalidated positive control range and for tests lacking sufficient patient RNA, and did not retract results or adequately refund Medicare.
DOJCivil settlementAug 26, 2026
DermTech Inc. to Pay Up to $5M to Resolve Allegations It Submitted False Claims to Medicare for Unreliable Skin Cancer Tests
DermTech Inc. billed Medicare for skin cancer tests conducted using an unvalidated positive control range and for tests with insufficient patient RNA, and did not retract the results or adequately refund Medicare.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4 Million to Settle False Claims Act Lawsuit
Monogram knowingly submitted diagnosis codes in four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to Medicare Advantage Organizations.
DOJCivil settlementAug 24, 2026
Medicare Advantage Provider Monogram Health Agrees to Pay $2.4M to Settle False Claims Act Suit
Monogram Health knowingly submitted diagnosis codes within four HCCs that were not clinically accurate, not supported by medical record documentation, and/or did not require or affect patient care, inflating Medicare Advantage beneficiaries' risk scores and causing CMS to make higher capitated payments to MAOs.
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.