Providers
All 19 in AL
SHANKAR B YALAMANCHILI, M.D.
NPI 1558332569, individual, Birmingham, AL, Psychiatry & Neurology, Psychiatry
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 9 months, but with up to 753 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 51 of 100, rank 9309, $361K 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 |
|---|---|---|---|---|---|---|---|---|---|
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 28.7 | 14.6 | 9.7 | 13.9 | 448 | 1 | 90792 99213 99221 99222 99231 99232 99238 | $20K |
| Jul 2018 | More hours than a day holds, even counting one unit per claim line | 24.9 | 13.9 | 9.3 | 13.0 | 389 | 1 | 90792 99221 99222 99231 99232 99238 99307 | $19K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 27.9 | 14.9 | 9.9 | 13.9 | 366 | 1 | 90792 99222 99223 99232 99233 99238 | $20K |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 28.6 | 12.7 | 8.5 | 12.5 | 415 | 1 | 90792 99222 99223 99231 99232 99233 99238 | $19K |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 26.9 | 6.1 | 4.1 | 5.5 | 187 | 1 | 99222 99223 99232 99233 99238 | $9K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 38.1 | 15.2 | 10.2 | 13.7 | 723 | 1 | 90791 90792 99222 99223 99232 99233 99238 | $33K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 40.1 | 18.6 | 12.4 | 16.9 | 753 | 1 | 90791 90792 99222 99223 99232 99233 99238 | $38K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 31.0 | 12.7 | 8.5 | 12.5 | 629 | 1 | 90791 90792 99222 99223 99232 99233 99238 | $27K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 24.7 | 17.8 | 11.9 | 16.0 | 397 | 1 | 90791 90792 99222 99223 99232 99233 99238 | $43K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SHANKAR B YALAMANCHILI, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | January 28, 2006, last updated December 16, 2024 |
| Practice location | 1509 6TH AVE S, Birmingham, AL 35233-1601, 205-930-3200 |
| Mailing address | 233 WINTON M BLOUNT LOOP, Montgomery, AL 36117-3507 |
| Specialties | Psychiatry & Neurology, Psychiatry (2084P0800X, primary, license 00026652 AL) |
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 | $473K | 41% | $68 | $67 (top 5% from $174) | 51st percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $211K | 18% | $45 | $96 (top 5% from $249) | 10th percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $199K | 17% | $65 | $81 (top 5% from $170) | 34th percentile | |
| 99238 | Hospital discharge day management, 30 minutes or less | $97K | 8% | $22 | $48 (top 5% from $80) | 11th percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $68K | 6% | $47 | $112 (top 5% from $313) | 18th percentile | |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | $46K | 4% | $37 | $63 (top 5% from $137) | 19th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $43K | 4% | $61 | $105 (top 5% from $228) | 21st percentile | |
| 99221 | Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes | $7K | 1% | $26 | $50 (top 5% from $194) | 16th 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 |
|---|---|---|---|---|---|---|---|---|
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 5,480 | 614 | $286K | $145 | $68 | 2.1x | 2.6x (90th percentile 4.3x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 1,490 | 518 | $119K | $219 | $103 | 2.1x | 2.6x (90th percentile 4.7x) |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 312 | 279 | $35K | $343 | $148 | 2.3x | 3.0x (90th percentile 5.6x) |
| 99238 | Hospital discharge day management, 30 minutes or less | 444 | 402 | $24K | $146 | $69 | 2.1x | 2.6x (90th percentile 4.7x) |
| 90792 | Psychiatric diagnostic evaluation with medical services | 190 | 183 | $22K | $483 | $152 | 3.2x | 2.2x (90th percentile 3.9x) |
| 99231 | Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes | 259 | 90 | $9K | $75 | $45 | 1.7x | 2.4x (90th percentile 4.0x) |
| 90791 | Psychiatric diagnostic evaluation | 92 | 89 | $9K | $304 | $135 | 2.2x | 1.9x (90th percentile 3.6x) |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 101 | 98 | $8K | $250 | $113 | 2.2x | 2.7x (90th percentile 4.4x) |
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
19 providers in Jefferson County, AL carry an indicator in the public record, with $18.8M at stake between them. The most common is more hours than a day holds, on 18 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | CARE COMPLETE MEDICAL CLINIC(CCMC)LLC Birmingham, AL, ranked 313 | $6K |
|
| 4 | PATRICK TAPIA Birmingham, AL, ranked 7745 | $1.5M |
|
| 4 | WALDEMAR CARLO Birmingham, AL, ranked 7796 | $1.2M |
|
| 4 | SONYA PRITCHARD Birmingham, AL, ranked 7800 | $1.2M |
|
| 4 | LINDY WINTER Birmingham, AL, ranked 7822 | $1.1M |
|
| 4 | JOSEPH PHILIPS Birmingham, AL, ranked 7901 | $673K |
|
| 4 | JEGEN KANDASAMY Birmingham, AL, ranked 7937 | $505K |
|
| 4 | CHARITHARTH LAL Birmingham, AL, ranked 7945 | $485K |
|
Recent enforcement in AL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Alabama Provider Pays $300,000 to Resolve False Claims as Part of 2026 National Health Care Fraud Takedown
A Phenix City-based provider billed Alabama Medicaid for Basic Living Skills services for at-risk children that were not actually rendered.
DOJSentencedApr 2, 2026
Former Medicaid Provider Sentenced to Federal Prison for Health Care Fraud and Aggravated Identity Theft
Pulliam, a child and family therapist enrolled as an Alabama Medicaid provider, submitted claims for counseling services that were never provided using beneficiaries' identifying information without consent.
DOJCivil judgmentMar 19, 2026
Mississippi Man Ordered to Pay $31 Million for Role in Healthcare Kickback Scheme
Crites and others referred patients, primarily TRICARE beneficiaries, to Cloverland Pharmacy in exchange for kickbacks paid by the pharmacy for each referral.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and thus ineligible for the Medicare hospice benefit.
DOJCivil settlementFeb 21, 2025
Saad Healthcare Agrees to Pay $3M to Settle False Claims Act Allegations That It Billed Medicare for Ineligible Hospice Patients
Saad Healthcare submitted, or caused the submission of, false claims to Medicare between 2013 and 2020 for 21 hospice patients who were not terminally ill and were ineligible for the Medicare hospice benefit.
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.