Providers
All 12 in CA
MARJORIE SHELTON-GROSS
NPI 1407068059, individual, Chico, CA, Obstetrics & Gynecology, Hospice and Palliative Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 50 months, but with up to 1211 patients a month across 9 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 52 of 100, rank 8402, $5.2M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds at a conservative unit price | 15.8 | 89.3 | 59.5 | 80.3 | 870 | 2 | 99201 99202 99203 99211 99212 99213 99214 | $161K |
| Feb 2018 | More hours than a day holds at a conservative unit price | 18.6 | 95.0 | 63.3 | 88.6 | 951 | 4 | 99201 99202 99203 99212 99213 99214 | $171K |
| Mar 2018 | More hours than a day holds at a conservative unit price | 19.9 | 96.9 | 64.6 | 91.0 | 1143 | 5 | 99201 99202 99203 99211 99212 99213 99214 | $205K |
| Apr 2018 | More hours than a day holds at a conservative unit price | 14.1 | 74.2 | 49.5 | 70.6 | 1067 | 5 | 99201 99202 99211 99212 99213 99214 | $145K |
| May 2018 | More hours than a day holds at a conservative unit price | 10.0 | 57.6 | 38.4 | 51.7 | 1077 | 4 | 99201 99202 99211 99212 99213 99214 | $118K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 9.0 | 51.2 | 34.2 | 48.8 | 958 | 5 | 99201 99202 99211 99212 99213 99214 | $100K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 9.4 | 52.4 | 34.9 | 49.2 | 1043 | 5 | 99201 99202 99211 99212 99213 99214 | $105K |
| Aug 2018 | More hours than a day holds at a conservative unit price | 11.1 | 58.7 | 39.1 | 52.7 | 1211 | 5 | 99201 99202 99211 99212 99213 99214 99402 | $127K |
| Sep 2018 | More hours than a day holds at a conservative unit price | 9.6 | 50.4 | 33.6 | 50.4 | 1010 | 4 | 99201 99202 99211 99212 99213 99214 | $109K |
| Oct 2018 | More hours than a day holds at a conservative unit price | 10.1 | 50.5 | 33.7 | 45.4 | 1206 | 5 | 99201 99202 99211 99212 99213 99214 | $116K |
| Dec 2018 | More hours than a day holds at a conservative unit price | 8.5 | 39.0 | 26.0 | 38.3 | 1011 | 5 | 99201 99202 99211 99212 99213 99214 | $88K |
| Jan 2019 | More hours than a day holds at a conservative unit price | 9.7 | 61.9 | 41.3 | 55.6 | 1208 | 5 | 99201 99202 99211 99212 99213 99214 | $105K |
| Feb 2019 | More hours than a day holds at a conservative unit price | 8.2 | 55.7 | 37.1 | 52.0 | 931 | 5 | 99201 99202 99211 99212 99213 99214 | $84K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 7.9 | 53.8 | 35.8 | 52.9 | 1058 | 6 | 99201 99202 99211 99212 99213 99214 | $89K |
| Apr 2019 | More hours than a day holds at a conservative unit price | 8.4 | 55.9 | 37.3 | 50.8 | 1038 | 6 | 99201 99202 99211 99212 99213 99214 | $92K |
| May 2019 | More hours than a day holds at a conservative unit price | 9.4 | 60.8 | 40.5 | 54.6 | 1173 | 6 | 99201 99202 99211 99212 99213 99214 | $104K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 8.1 | 55.5 | 37.0 | 55.5 | 984 | 5 | 99201 99202 99211 99212 99213 99214 | $90K |
| Jul 2020 | More hours than a day holds at a conservative unit price | 7.9 | 85.9 | 57.2 | 77.2 | 1035 | 5 | 99201 99202 99211 99212 99213 | $79K |
| Aug 2020 | More hours than a day holds at a conservative unit price | 7.3 | 76.1 | 50.7 | 74.9 | 989 | 5 | 99201 99202 99203 99211 99212 99213 | $74K |
| Sep 2020 | More hours than a day holds at a conservative unit price | 8.9 | 96.7 | 64.5 | 87.9 | 1142 | 5 | 99201 99202 99212 99213 99214 | $91K |
| Oct 2020 | More hours than a day holds at a conservative unit price | 8.8 | 96.9 | 64.6 | 91.0 | 1132 | 5 | 99201 99202 99212 99213 99214 | $93K |
| Nov 2020 | More hours than a day holds at a conservative unit price | 8.2 | 80.3 | 53.5 | 76.4 | 981 | 5 | 99201 99202 99212 99213 99214 | $79K |
| Dec 2020 | More hours than a day holds at a conservative unit price | 8.4 | 66.1 | 44.0 | 59.4 | 896 | 5 | 99201 99202 99203 99212 99213 99214 | $74K |
| Jan 2021 | More hours than a day holds at a conservative unit price | 8.6 | 66.4 | 44.3 | 65.3 | 918 | 5 | 99202 99203 99212 99213 99214 | $80K |
| Feb 2021 | More hours than a day holds at a conservative unit price | 8.1 | 64.7 | 43.1 | 60.4 | 768 | 5 | 99202 99203 99212 99213 99214 | $68K |
| Mar 2021 | More hours than a day holds at a conservative unit price | 9.1 | 68.9 | 46.0 | 62.0 | 972 | 5 | 99202 99203 99212 99213 99214 | $85K |
| Apr 2021 | More hours than a day holds at a conservative unit price | 4.5 | 37.7 | 25.1 | 34.3 | 466 | 2 | 99202 99203 99212 99213 99214 | $47K |
| Jun 2021 | More hours than a day holds at a conservative unit price | 7.0 | 49.8 | 33.2 | 45.3 | 733 | 5 | 99202 99203 99212 99213 99214 | $69K |
| Jul 2021 | More hours than a day holds at a conservative unit price | 6.3 | 44.8 | 29.8 | 42.0 | 643 | 5 | 99202 99203 99212 99213 99214 | $64K |
| Aug 2021 | More hours than a day holds at a conservative unit price | 8.3 | 66.2 | 44.1 | 62.2 | 955 | 5 | 99202 99203 99212 99213 99214 | $88K |
| Sep 2021 | More hours than a day holds at a conservative unit price | 7.5 | 53.9 | 35.9 | 49.0 | 784 | 5 | 99202 99203 99212 99213 99214 | $76K |
| Oct 2021 | More hours than a day holds at a conservative unit price | 7.3 | 58.9 | 39.3 | 58.0 | 856 | 6 | 99202 99203 99212 99213 99214 | $79K |
| Nov 2021 | More hours than a day holds at a conservative unit price | 6.1 | 48.3 | 32.2 | 43.9 | 695 | 6 | 99202 99203 99212 99213 99214 | $63K |
| Dec 2021 | More hours than a day holds at a conservative unit price | 6.6 | 47.5 | 31.7 | 42.7 | 704 | 5 | 99202 99203 99212 99213 99214 | $70K |
| Jan 2022 | More hours than a day holds at a conservative unit price | 6.7 | 41.2 | 27.5 | 40.6 | 627 | 5 | 99202 99203 99212 99213 99214 | $70K |
| Feb 2022 | More hours than a day holds at a conservative unit price | 7.1 | 48.6 | 32.4 | 45.4 | 699 | 5 | 99202 99203 99212 99213 99214 | $65K |
| Mar 2022 | More hours than a day holds at a conservative unit price | 7.9 | 48.9 | 32.6 | 43.9 | 789 | 6 | 99202 99203 99212 99213 99214 | $77K |
| Apr 2022 | More hours than a day holds at a conservative unit price | 7.5 | 47.4 | 31.6 | 45.2 | 816 | 7 | 99202 99203 99212 99213 99214 | $73K |
| Aug 2022 | More hours than a day holds at a conservative unit price | 7.3 | 42.4 | 28.3 | 38.1 | 844 | 6 | 99202 99203 99212 99213 99214 | $61K |
| Sep 2022 | More hours than a day holds at a conservative unit price | 5.9 | 38.5 | 25.7 | 35.0 | 698 | 6 | 99202 99203 99212 99213 99214 | $54K |
| Dec 2022 | More hours than a day holds at a conservative unit price | 6.7 | 41.6 | 27.7 | 39.1 | 779 | 6 | 99202 99203 99212 99213 99214 | $63K |
| Jan 2023 | More hours than a day holds at a conservative unit price | 7.2 | 47.3 | 31.5 | 44.4 | 877 | 7 | 99202 99203 99212 99213 99214 | $70K |
| Feb 2023 | More hours than a day holds at a conservative unit price | 6.6 | 43.2 | 28.8 | 40.4 | 770 | 8 | 99202 99203 99212 99213 99214 | $57K |
| Mar 2023 | More hours than a day holds at a conservative unit price | 7.1 | 49.6 | 33.1 | 44.6 | 886 | 7 | 99202 99203 99212 99213 99214 | $70K |
| May 2023 | More hours than a day holds at a conservative unit price | 5.0 | 36.3 | 24.2 | 32.6 | 690 | 6 | 99202 99212 99213 99214 | $50K |
| Jun 2023 | More hours than a day holds at a conservative unit price | 5.4 | 38.0 | 25.4 | 34.6 | 787 | 8 | 99202 99212 99213 | $54K |
| Jul 2023 | More hours than a day holds at a conservative unit price | 6.4 | 40.3 | 26.9 | 39.6 | 824 | 7 | 99202 99203 99212 99213 99214 | $58K |
| Aug 2023 | More hours than a day holds at a conservative unit price | 7.4 | 42.3 | 28.2 | 38.0 | 1039 | 9 | 99202 99203 99211 99212 99213 | $66K |
| Oct 2023 | More hours than a day holds at a conservative unit price | 6.3 | 41.0 | 27.3 | 38.5 | 910 | 8 | 99202 99211 99212 99213 99214 | $60K |
| Nov 2023 | More hours than a day holds at a conservative unit price | 6.5 | 45.1 | 30.1 | 41.0 | 856 | 7 | 99202 99203 99212 99213 99214 | $65K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | MARJORIE SHELTON-GROSS |
| Type | Individual |
| Status | Active |
| NPI issued | May 4, 2007, last updated December 1, 2014 |
| Practice location | 1469 HUMBOLDT RD, SUITE 200, Chico, CA 95928-9116, 530-891-1917 |
| Mailing address | 1442 ETHAN WAY, SUITE 200, Sacramento, CA 95825-2231 |
| Specialties | Obstetrics & Gynecology, Hospice and Palliative Medicine (207VH0002X, primary, license G455730 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 | |
|---|---|---|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $1.8M | 14% | $64 | $28 (top 5% from $147) | 86th percentile | |
| S0199 | Medicaid service code | $1.7M | 12% | $379 | $439 (top 5% from $595) | 39th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.5M | 11% | $85 | $44 (top 5% from $110) | 90th percentile | |
| J7307 | Medicaid service code | $1.2M | 9% | $862 | $827 (top 5% from $1K) | 58th percentile | |
| J3490 | Unclassified drugs | $1.1M | 8% | $36 | $4.55 (top 5% from $108) | 85th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $748K | 6% | $168 | $60 (top 5% from $133) | 98th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $697K | 5% | $113 | $45 (top 5% from $138) | 93rd percentile | |
| J7298 | Medicaid service code | $628K | 5% | $883 | $787 (top 5% from $1K) | 63rd percentile |
In this area
12 providers in Butte County, CA carry an indicator in the public record, with $16.9M at stake between them. The most common is more hours than a day holds, on 11 of them, followed by part of a provider network on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | FEATHER RIVER CARE CENTER LLC Oroville, CA, ranked 7041 | $0 |
|
| 4 | CHESTER AUSTIN Chico, CA, ranked 7637 | $2.4M |
|
| 4 | CHUKWUEMEKA NDULUE Gridley, CA, ranked 7639 | $2.3M |
|
| 4 | HEATHER O'CONNELL Chico, CA, ranked 7810 | $1.1M |
|
| 4 | JOE TAYLOR Chico, CA, ranked 8117 | $2.7M |
|
| 4 | MARK HEINRICH Oroville, CA, ranked 8432 | $4.5M |
|
| 4 | NARINDER SINGH Oroville, CA, ranked 8846 | $1.4M |
|
| 4 | ALYSSA MILLIRON Chico, CA, ranked 9761 | $4K |
|
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.