ROHIT GOUREE RAMANATH, MD
NPI 1457622003, individual, Franklin Lakes, NJ, General Practice
- Hours beyond a day in 3 months, but with up to 1691 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 2020 | More hours than a day holds at a conservative unit price | 22.0 | 40.9 | 27.2 | 37.1 | 1475 | 1 | 99203 99213 | $149K |
| Oct 2020 | More hours than a day holds at a conservative unit price | 23.7 | 45.4 | 30.3 | 42.7 | 1691 | 1 | 99203 99213 | $172K |
| Dec 2020 | More hours than a day holds at a conservative unit price | 19.1 | 36.5 | 24.3 | 32.8 | 1357 | 1 | 99202 99203 99212 99213 | $138K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ROHIT GOUREE RAMANATH, MD |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | January 13, 2012, last updated October 16, 2014 |
| Practice location | 619 OSIO LN, Franklin Lakes, NJ 07417-1809, 201-337-7941 |
| Specialties | General Practice (208D00000X, primary, license 53349 CT) |
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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $895K | 24% | $79 | $44 (top 5% from $110) | 88th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $866K | 23% | $115 | $67 (top 5% from $121) | 94th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $637K | 17% | $111 | $60 (top 5% from $133) | 90th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $414K | 11% | $166 | $95 (top 5% from $171) | 94th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $261K | 7% | $36 | $32 (top 5% from $49) | 65th percentile | |
| 87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | $167K | 4% | $49 | $44 (top 5% from $70) | 66th percentile | |
| 0241U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected | $150K | 4% | $130 | $113 (top 5% from $189) | 63rd percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $103K | 3% | $48 | $28 (top 5% from $147) | 79th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 152 | 128 | $13K | $350 | $134 | 2.6x | 2.3x (90th percentile 3.8x) |
| 0241U | Respiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected | 94 | 91 | $13K | $357 | $140 | 2.6x | 2.0x (90th percentile 3.2x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 186 | 165 | $12K | $247 | $95 | 2.6x | 2.2x (90th percentile 3.8x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 76 | 76 | $9K | $452 | $173 | 2.6x | 2.4x (90th percentile 3.9x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 78 | 78 | $6K | $304 | $117 | 2.6x | 2.4x (90th percentile 3.9x) |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 97 | 16 | $4K | $125 | $50 | 2.5x | 1.9x (90th percentile 3.1x) |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 26 | 26 | $4K | $250 | $135 | 1.8x | 2.3x (90th percentile 4.1x) |
| 99458 | Management using the results of remote vital sign monitoring per calendar month, each additional 20 minutes | 108 | 18 | $3K | $105 | $41 | 2.6x | 2.2x (90th percentile 3.5x) |
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
15 providers in Bergen County, NJ carry an indicator in the public record, with $10.4M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by paid after a public list action on 2. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | INFINITY DIAGNOSTICS LABORATORY, INC Teterboro, NJ, ranked 3 | $1.0M |
|
| 1 | BERGEN ALLIANCE COUNSELING SERVICE Waldwick, NJ, ranked 616 | $0 |
|
| 3 | RITESH KALRA Fair Lawn, NJ, ranked 1198 | $376K |
|
| 3 | EMERSON CONVALESCENT CENTER INC Emerson, NJ, ranked 3143 | $0 |
|
| 3 | 120-124 NOYES DRIVE OPERATING COMPANY LLC Park Ridge, NJ, ranked 4966 | $0 |
|
| 4 | DONNA DEPHILLIPS Old Tappan, NJ, ranked 7990 | $323K |
|
| 4 | SHELLA CAJITA Ridgefield, NJ, ranked 9544 | $128K |
|
| 5 | DONGJIN KIM Englewood, NJ, ranked 9987 | $1.8M |
|
Recent enforcement in NJ
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.