SAGAR H PATEL, MD

NPI 1386725570, individual, Jackson, MS, Psychiatry & Neurology, Sleep Medicine

Evidence tier

structure or single-organization volume

Hours beyond a day in 2 months under one organization, which can be supervisory billing.
Records needed.
Medicaid dollars per patient on code 99232 ($184 per patient-month) sit in the top 5% of every provider billing that code.

score 55 of 100, rank 7867, $846K 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
Feb 2019	More hours than a day holds, even counting one unit per claim line	29.9	26.5	17.7	24.7	209	2	99223 99232 99238	$25K
Mar 2019	More hours than a day holds, even counting one unit per claim line	24.1	26.7	17.8	26.3	209	2	99223 99232 99238	$28K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	SAGAR H PATEL, MD
Type	Individual, sole proprietor
Status	Active
NPI issued	October 17, 2006, last updated May 13, 2025
Practice location	1920 DUNBARTON DR, Jackson, MS 39216-5001, 601-982-5376
Mailing address	117 KLAAS BLVD, Madison, MS 39110-9118
Specialties	Psychiatry & Neurology, Sleep Medicine (2084S0012X, primary, license 20272 MS)

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
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	$960K	57%	$184	$67 (top 5% from $174)	96th percentile
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	$402K	24%	$128	$81 (top 5% from $170)	85th percentile
99238	Hospital discharge day management, 30 minutes or less	$209K	12%	$50	$48 (top 5% from $80)	53rd percentile
90792	Psychiatric diagnostic evaluation with medical services	$40K	2%	$141	$112 (top 5% from $313)	67th percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$35K	2%	$51	$44 (top 5% from $110)	61st percentile
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	$26K	2%	$102	$63 (top 5% from $137)	84th percentile
99231	Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	$25K	1%	$75	$37 (top 5% from $103)	87th percentile
99221	Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes	$856	0%	$61	$50 (top 5% from $194)	too few months to rank

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
95811	Sleep study in sleep lab with continuous airway pressure (6 years or older)	46	22	$9K	$2K	$253	6.5x	3.4x (90th percentile 8.7x)
95810	Sleep study in sleep lab (6 years or older)	48	24	$9K	$1K	$242	5.8x	3.4x (90th percentile 8.4x)
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	79	42	$4K	$125	$75	1.7x	2.2x (90th percentile 3.8x)
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	53	15	$3K	$200	$72	2.8x	2.6x (90th percentile 4.3x)
90792	Psychiatric diagnostic evaluation with medical services	16	16	$2K	$350	$160	2.2x	2.2x (90th percentile 3.9x)

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

5 providers in Hinds County, MS carry an indicator in the public record, with $45.1M at stake between them. The most common is more hours than a day holds, on 5 of them.

tier	provider	at stake	why
2	JOHN WILKAITIS Jackson, MS, ranked 697	$1.6M	Billed more hands-on hours than a day holds in 2 months, peaking at 24.6 hours per day across 3 billing organizations. Medicaid dollars per patient on code 99232 ($286 per patient-month) sit in the top 5% of every provider billing that code.
4	TIMOTHY ESTES Jackson, MS, ranked 8050	$149K	Hours beyond a day in 1 month, but with up to 1648 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed. and 1 more
5	KULMORIS JOINER Jackson, MS, ranked 10295	$42.7M	90% of Medicaid dollars are on codes with a history of abuse.
5	PATRICK WELDON Jackson, MS, ranked 10297	$425K	Medicaid dollars per patient on code 99232 ($178 per patient-month) sit in the top 5% of every provider billing that code.
5	KRISHAN GUPTA Jackson, MS, ranked 10392	$197K	Medicaid dollars per patient on code 99232 ($244 per patient-month) sit in the top 5% of every provider billing that code.

Recent enforcement in MS

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

DOJSentencedJun 30, 2026

Madison Man Sentenced to 30 Months in Federal Prison for Role in Medicare Kickback Conspiracy

Smith, a marketer for diagnostic laboratories, solicited and received kickbacks from laboratories in exchange for referrals of specimens and orders for molecular diagnostic testing of toenails and paid kickbacks to providers to induce those referrals, resulting in over $1.4 million in claims to Medicare.

DOJSentencedJun 29, 2026

Two Corinth Pharmacists Sentenced for Conspiracy to Commit Healthcare Fraud

Two pharmacists billed Medicare and Medicaid for the same single prescription drug product numerous times, including diabetic insulin pens, asthma inhalers and psychotropic medications.

DOJSentencedMay 8, 2026

Former NFL Player Sentenced to Over 16 Years in Prison for $197M Medicare Fraud

French worked with overseas call centers to obtain patient information, paid kickbacks to sham telemedicine companies for signed doctors' orders for orthotic braces, sold the orders to marketers and supply companies, and billed Medicare and CHAMPVA through eight DME companies he owned using straw owners.

DOJPleaded guiltyNov 20, 2025

Mississippi Businessman Pleads Guilty to $19M Health Care Fraud Conspiracy

Gibbs paid kickbacks for fraudulent doctors' orders and used them to bill Medicare over $19 million for medically unnecessary orthotic braces through seven durable medical equipment supply companies he owned or controlled, sometimes through straw owners.

DOJCivil settlementAug 22, 2025

MISSISSIPPI MEDICAID RECIPIENTS AGREE TO PAY OVER $170,000 TO RESOLVE FALSE CLAIMS ACT ALLEGATIONS OF HEALTH CARE BENEFITS FRAUD

Former Medicaid recipients allegedly falsified their income on Mississippi Medicaid applications and renewals to create eligibility for health care benefits for their dependents.

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.

Ask this case

Answers come only from the evidence tables, and every sentence cites the record it used.