Providers
All 11 in GA
ANAND P LALAJI, MD
NPI 1649245747, individual, Atlanta, GA, Radiology, Diagnostic Radiology
1
Evidence tier
documented action, then payment
- Listed on a Department of Justice release and the KY Medicaid exclusion list since November 16, 2023.
- Medicaid still paid claims in 12 later months, $19,383 in total.
score 94 of 100, rank 245, $19K at stake
Public list actions
Medicare revocation effective January 17, 2025, barred from re-enrolling until January 16, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, GA
Medicare revocation effective January 5, 2025, barred from re-enrolling until January 4, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, LA
Medicare revocation effective January 5, 2025, barred from re-enrolling until January 4, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, NY
Medicare revocation effective January 17, 2025, barred from re-enrolling until January 16, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, SC
Medicare revocation effective January 4, 2025, barred from re-enrolling until January 3, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, FL
Medicare revocation effective January 5, 2025, barred from re-enrolling until January 4, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, CA
Medicare revocation effective January 5, 2025, barred from re-enrolling until January 4, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, NJ
Medicare revocation effective January 17, 2025, barred from re-enrolling until January 16, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, TN
Medicare revocation effective January 9, 2025, barred from re-enrolling until January 8, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, KY
Medicare revocation effective January 5, 2025, barred from re-enrolling until January 4, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, TX
Medicare revocation effective January 5, 2025, barred from re-enrolling until January 4, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, CT
Medicare revocation effective January 16, 2025, barred from re-enrolling until January 15, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, WV
Medicare revocation effective January 8, 2025, barred from re-enrolling until January 7, 2035
424.535(a)(4) false or misleading information and 424.535(a)(9) failure to report, Practitioner - Diagnostic Radiology, AZ
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| KY Medicaid exclusion list state list extracted from https://chfs.ky.gov/agencies/dms/dpi/pe/documents/kymedicaidterminationlist.xlsx (pandas claude colmap) | Exact NPI, name verified | Nov 16, 2023 | still open | 12 | Dec 2023 | Nov 2024 | $19K | $64K |
| doj admin enforcement record (civil settlement): u.s. attorney announces $3.1 million false claims act settlement with radiology company and its ceo for fraudulent billing practices | No NPI on the list; matched by name at high confidence | Mar 27, 2024 | still open | 8 | Apr 2024 | Nov 2024 | $2K | $82K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ANAND P LALAJI, MD |
| Type | Individual |
| Status | Active |
| NPI issued | February 22, 2006, last updated July 9, 2021 |
| Practice location | 3475 PIEDMONT RD NE, STE 1150, Atlanta, GA 30305-3003, 404-946-9633 |
| Specialties | Radiology, Diagnostic Radiology (2085R0202X, license 26875 WV) Radiology, Diagnostic Radiology (2085R0202X, primary, license 050198 GA) |
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 | |
|---|---|---|---|---|---|---|---|
| 74176 | Ct scan of abdomen and pelvis without contrast | $147K | 20% | $40 | $51 (top 5% from $293) | 27th percentile | |
| 74177 | Ct scan of abdomen and pelvis with contrast | $131K | 17% | $45 | $59 (top 5% from $362) | 21st percentile | |
| 70450 | Ct scan head or brain without contrast | $113K | 15% | $21 | $29 (top 5% from $228) | 20th percentile | |
| 71045 | X-ray of chest, 1 view | $45K | 6% | $3.79 | $5.95 (top 5% from $56) | 18th percentile | |
| 71046 | X-ray of chest, 2 views | $35K | 5% | $5.44 | $8.15 (top 5% from $65) | 16th percentile | |
| 72125 | Ct scan of upper spine without contrast | $29K | 4% | $29 | $33 (top 5% from $168) | 37th percentile | |
| 76815 | Limited ultrasound of pregnant uterus | $27K | 4% | $21 | $32 (top 5% from $105) | 22nd percentile | |
| 71250 | Ct scan of chest without contrast | $19K | 3% | $23 | $35 (top 5% from $170) | 21st 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 |
|---|---|---|---|---|---|---|---|---|
| 70450 | Ct scan head or brain without contrast | 104 | 99 | $2K | $155 | $39 | 4.0x | 4.9x (90th percentile 12.9x) |
| 74176 | Ct scan of abdomen and pelvis without contrast | 36 | 36 | $2K | $274 | $80 | 3.4x | 4.4x (90th percentile 12.0x) |
| 71275 | Ct scan of blood vessels of chest with contrast | 23 | 23 | $1K | $346 | $80 | 4.3x | 4.4x (90th percentile 11.8x) |
| 71045 | X-ray of chest, 1 view | 141 | 123 | $831 | $26 | $8 | 3.1x | 4.4x (90th percentile 12.7x) |
| 74177 | Ct scan of abdomen and pelvis with contrast | 15 | 14 | $729 | $303 | $78 | 3.9x | 4.4x (90th percentile 11.2x) |
| 71250 | Ct scan of chest without contrast | 20 | 20 | $632 | $177 | $50 | 3.6x | 4.7x (90th percentile 11.9x) |
| 72125 | Ct scan of upper spine without contrast | 26 | 26 | $612 | $208 | $45 | 4.6x | 4.9x (90th percentile 13.1x) |
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
11 providers in Fulton County, GA carry an indicator in the public record, with $15.4M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 3. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | RAJASHAKHER REDDY Alpharetta, GA, ranked 151 | $96K |
|
| 1 | JEFFREY GALLUPS Alpharetta, GA, ranked 172 | $61K |
|
| 2 | SIGRID ELSTON Atlanta, GA, ranked 686 | $14.1M |
|
| 3 | CREATIVE HOSPICE CARE INC Roswell, GA, ranked 2511 | $0 |
|
| 3 | AFFINITY CARE OF GEORGIA LLC Atlanta, GA, ranked 3336 | $0 |
|
| 3 | RUTLEDGE MEDICAL ASSOCIATES LLC East Point, GA, ranked 5925 | $0 |
|
| 3 | ENNOBLE HOSPICE GA LLC Sandy Springs, GA, ranked 7024 | $0 |
|
| 4 | PANCHAJANYA PAUL Atlanta, GA, ranked 7929 | $532K |
|
Recent enforcement in GA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJIndictedAug 24, 2026
Southern District of Georgia federal indictments include murder, drug- and firearm-related charges and healthcare fraud
Perry Patalano was indicted for Healthcare Fraud, Theft of Government Money, Property or Records, and Aggravated Identity Theft.
DOJChargedJun 24, 2026
Two Georgia Men Charged in National Health Care Fraud Takedown
Rutledge billed Georgia Medicaid for thousands of wound care, cyst removal, psychotherapy, and allergy testing services that were never performed, and Releford obtained nursing jobs by lying about his qualifications and stealing a licensed practical nurse's identity, causing providers to bill Medicare and Medicaid for services he could not legally perform.
DOJSentencedMay 4, 2026
Two Sentenced to Prison for $522M Genetic Testing Fraud and Illegal Kickback Scheme Targeting Medicare and Medicaid
Two men who controlled four laboratories paid kickbacks and bribes to marketers to obtain DNA samples and fraudulent requisition forms from medical providers, resulting in approximately $522 million in false claims for medically unnecessary genetic tests.
DOJPleaded guiltyApr 14, 2026
Behavioral therapist pleads guilty to health care fraud for submitting inflated insurance reimbursement claims
From June 2020 through May 2023, Stallings submitted false and fraudulent billing claims to TRICARE for individual and group therapy services that were not provided or were not provided as presented, and also obtained COVID-19 Economic Injury Disaster Loan funds that she spent on personal purposes.
DOJSentencedDec 2, 2025
Georgia Man Sentenced for $24M Kickback and Medicare Fraud Conspiracy
Moore instructed a network of recruiters to induce Medicare beneficiaries to accept medically unnecessary genetic tests, received approximately $4.3 million in kickbacks for referring beneficiary information, DNA specimens and doctors' orders, and concealed the payments with sham invoices.
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.