JOHN XIAO-JIANG QIAN, M.D.

NPI 1649290891, individual, San Diego, CA, Physical Medicine & Rehabilitation, Pain Medicine

Evidence tier

documented action, then payment

Listed on the CA Medicaid exclusion list since February 11, 2022.
Medicaid still paid claims in 5 later months, $23,392 in total.
Hours beyond a day in 11 months, but with up to 782 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
Records needed.
A second detector adds a weaker signal.

score 94 of 100, rank 232, $23K at stake

Public list actions

Medicare revocation effective July 23, 2022, barred from re-enrolling until July 21, 2027

424.535(a)(13) prescribing authority, Practitioner - Pain Management, CA

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
CA Medicaid exclusion list ca medi-cal suspended & ineligible provider list (july 2026)	Exact NPI, name verified	Feb 11, 2022	still open	5	Mar 2022	Jul 2022	$23K	$275K

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	13.5	43.2	28.8	38.8	774	2	99205 99213 99214	$81K
Jan 2019	More hours than a day holds at a conservative unit price	11.4	39.5	26.4	35.5	591	1	99205 99213 99214	$75K
Feb 2019	More hours than a day holds at a conservative unit price	10.6	36.0	24.0	33.6	521	1	99205 99213 99214	$61K
Mar 2019	More hours than a day holds at a conservative unit price	11.5	37.3	24.8	36.7	587	1	99204 99205 99213 99214	$71K
Apr 2019	More hours than a day holds at a conservative unit price	15.2	48.4	32.3	44.0	781	1	99204 99205 99213 99214 99215	$91K
May 2019	More hours than a day holds at a conservative unit price	13.1	43.8	29.2	39.4	719	1	99204 99205 99213 99214	$80K
Jun 2019	More hours than a day holds at a conservative unit price	10.8	37.3	24.9	37.3	643	1	99203 99205 99213 99214	$64K
Jul 2019	More hours than a day holds at a conservative unit price	13.8	45.2	30.1	40.6	767	1	99203 99204 99205 99213 99214	$85K
Aug 2019	More hours than a day holds at a conservative unit price	13.7	46.6	31.1	43.8	752	1	99204 99205 99213 99214	$85K
Sep 2019	More hours than a day holds at a conservative unit price	12.1	40.1	26.7	38.2	661	1	99205 99213 99214 99215	$73K
Oct 2019	More hours than a day holds at a conservative unit price	14.2	48.3	32.2	43.4	782	1	99205 99213 99214 99215	$89K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	JOHN XIAO-JIANG QIAN, M.D.
Type	Individual
Status	Active
NPI issued	July 20, 2006, last updated February 19, 2013
Practice location	5395 RUFFIN ROAD., STE. 204, San Diego, CA 92123-1338, 858-571-3630
Specialties	Physical Medicine & Rehabilitation, Pain Medicine (2081P2900X, primary, license A72430 CA) Pain Medicine, Interventional Pain Medicine (208VP0014X, license A72430 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
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$1.3M	54%	$111	$60 (top 5% from $133)	90th percentile
99205	New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	$188K	8%	$189	$128 (top 5% from $249)	81st percentile
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	$164K	7%	$74	$44 (top 5% from $110)	85th percentile
20611	Aspiration and/or injection of fluid large joint using ultrasound guidance	$123K	5%	$115	$57 (top 5% from $195)	88th percentile
62323	Injection of substance into lower spine canal using imaging guidance	$83K	4%	$222	$130 (top 5% from $514)	78th percentile
99152	Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes	$79K	3%	$51	$9.26 (top 5% from $48)	96th percentile
72275	Medicaid service code	$66K	3%	$107	$34 (top 5% from $109)	93rd percentile
64493	Injection of lower or sacral spine facet joint using imaging guidance, single level	$59K	2%	$192	$125 (top 5% from $689)	69th percentile

In this area

141 providers in San Diego County, CA carry an indicator in the public record, with $221.8M at stake between them. The most common is more hours than a day holds, on 82 of them, followed by part of a provider network on 43. 11 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	BRENTON WYNN National City, CA, ranked 19	$52K	Listed on the CA Medicaid exclusion list and the Medicare revocation list since May 23, 2022. Medicaid still paid claims in 6 later months, $51,770 in total. and 1 more
1	MICHAEL I KELLER M.D. INC San Diego, CA, ranked 124	$141K	Listed on the CA Medicaid exclusion list since December 10, 2020. Medicaid still paid claims in 18 later months, $141,240 in total.
1	BRENTON D. WYNN, MD INC National City, CA, ranked 135	$125K	Listed on the CA Medicaid exclusion list since May 23, 2022. Medicaid still paid claims in 27 later months, $125,367 in total.
1	BRUCE BAKER Poway, CA, ranked 144	$107K	Listed on the CA Medicaid exclusion list since July 13, 2020. Medicaid still paid claims in 3 later months, $106,617 in total.
1	KYUNG BOEN San Marcos, CA, ranked 191	$50K	Listed on the WA Medicaid exclusion list since April 7, 2017. Medicaid still paid claims in 16 later months, $50,384 in total.
1	ROOZBEH BADII San Diego, CA, ranked 199	$45K	Listed on the OIG exclusion list and the NY Medicaid exclusion list and the CA Medicaid exclusion list since February 15, 2018. Medicaid still paid claims in 15 later months, $44,839 in total.
1	CHIVANO CHHIENG San Diego, CA, ranked 231	$24K	Listed on the CA Medicaid exclusion list since July 14, 2020. Medicaid still paid claims in 12 later months, $23,669 in total.
1	CHRISTOPHER HOLT San Diego, CA, ranked 350	$3K	Listed on the CA Medicaid exclusion list since June 29, 2021. Medicaid still paid claims in 3 later months, $2,891 in total.

All 141 in CA

Recent enforcement in CA

All releases

Department 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.

Ask this case

Answers come only from the evidence tables, and every sentence cites the record it used.