SUSAN FRANCES JULIUS, MD

NPI 1407921935, individual, Baton Rouge, LA, Family Medicine, Addiction Medicine

Evidence tier

structure or single-organization volume

Hours beyond a day in 1 month under one organization, which can be supervisory billing.
Records needed.
Medicaid dollars per patient on code 80307 ($197 per patient-month) sit in the top 5% of every provider billing that code.

score 53 of 100, rank 8131, $22K 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
Mar 2023	More hours than a day holds, even counting one unit per claim line	27.1	11.0	7.3	9.9	326	1	90792 99223 99231 99232 99238	$22K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	SUSAN FRANCES JULIUS, MD (also SUSAN SUMERGRAD)
Type	Individual
Status	Active
NPI issued	November 21, 2006, last updated August 28, 2024
Practice location	2414 BUNKER HILL DR, Baton Rouge, LA 70808-3303, 225-590-7472
Mailing address	195 HIGHLAND PARK PLZ STE 100, Covington, LA 70433-7128
Specialties	Family Medicine (207Q00000X, license 022649 LA) Family Medicine, Addiction Medicine (207QA0401X, primary, license 022649 LA)

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
80307	Testing for presence of drug, by chemistry analyzers	$567K	60%	$197	$45 (top 5% from $110)	99th percentile
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	$109K	12%	$114	$96 (top 5% from $249)	62nd percentile
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	$78K	8%	$114	$81 (top 5% from $170)	77th percentile
90792	Psychiatric diagnostic evaluation with medical services	$63K	7%	$86	$112 (top 5% from $313)	33rd percentile
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	$42K	4%	$57	$67 (top 5% from $174)	39th percentile
99231	Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes	$34K	4%	$42	$37 (top 5% from $103)	58th percentile
99239	Hospital discharge day management, more than 30 minutes	$16K	2%	$64	$49 (top 5% from $101)	69th percentile
99238	Hospital discharge day management, 30 minutes or less	$13K	1%	$38	$48 (top 5% from $80)	33rd percentile

In this area

12 providers in East Baton Rouge Parish County, LA carry an indicator in the public record, with $3.1M at stake between them. The most common is part of a provider network, on 5 of them, followed by more hours than a day holds on 5. 2 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	ACADIAN DIAGNOSTIC LABORATORIES LLC Baton Rouge, LA, ranked 28	$9K	Listed on the CO Medicaid exclusion list since October 16, 2020. Medicaid still paid claims in 5 later months, $9,393 in total. and 1 more
1	STAT CARE CLINICS Baton Rouge, LA, ranked 97	$324K	Listed on the Medicare revocation list since March 1, 2024. Medicaid still paid claims in 7 later months, $323,783 in total.
3	LANE SENIOR CARE LLC Zachary, LA, ranked 3002	$0	Part of provider network D1-00101, ranked 101 nationally.
3	LA WESTFORK, LLC Baton Rouge, LA, ranked 4399	$0	Part of provider network D1-00080, ranked 80 nationally.
3	LA OLD HAMMOND HWY, LLC Baton Rouge, LA, ranked 4505	$0	Part of provider network D1-00080, ranked 80 nationally.
3	HOSPICE IN HIS CARE, LLC Baton Rouge, LA, ranked 6041	$0	Part of provider network D1-00101, ranked 101 nationally.
3	SUPERIOR HOME HEALTH CARE INC Baton Rouge, LA, ranked 6334	$0	Part of provider network D1-00101, ranked 101 nationally.
4	TARA DIXON Baton Rouge, LA, ranked 8195	$889K	Hours beyond a day in 21 months under one organization, which can be supervisory billing. Records needed. and 1 more

All 12 in LA

Recent enforcement in LA

All releases

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

DOJOtherJul 30, 2026

Louisiana U.S. Attorneys Highlight Nine Recent Fraud Prosecutions Across the State

A nurse practitioner was sentenced for a health care fraud scheme involving over $12 million in fraudulent Medicare claims for medically unnecessary cancer genetic tests and receipt of kickbacks, and a New Orleans physician was charged with health care fraud for allegedly submitting $5.9 million in fraudulent claims to Medicare, Medicaid, and Humana for care not provided, in-person care for patients outside the state, and claims using other providers' identities.

DOJChargedJun 23, 2026

National Health Care Fraud Takedown Results in 455 Defendants Charged in Fraud Scheme Totaling Over $6.5 Billion

Defendants were charged in connection with schemes to submit claims for medically unnecessary respiratory pathogen panel testing, claims for care a physician did not provide, and false Medicaid claims for personal care services not rendered.

DOJSentencedJun 17, 2026

Nurse Practitioner Sentenced to 87 Months in Prison for $12M Medicare Fraud

A nurse practitioner received kickbacks for signing hundreds of orders for medically unnecessary cancer genetic tests after brief phone calls with patients without examining them, causing over $12.1 million in false and fraudulent claims to Medicare.

DOJSentencedApr 10, 2026

Slidell Doctor Sentenced For $6.6 Million In Health Care Fraud

Tassin, working through purported telemedicine companies, signed doctors' orders for cancer genetic tests for Medicare beneficiaries he never saw, spoke to, or treated, falsely certifying medical necessity in exchange for a set fee of typically $30 per order.

DOJSentencedJan 28, 2026

Slidell Chiropractor Sentenced For Health Care Fraud

Peyroux conspired with others to purchase Medicare beneficiary information and fabricated recordings and billed Medicare through his chiropractic clinic for over-the-counter COVID-19 test kits that were not requested or were otherwise ineligible for reimbursement, falsely listing a former nurse practitioner as the referring provider.

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.

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