KISHORE K SRIRAM, M.D.
NPI 1710179908, individual, Warsaw, IN, Psychiatry & Neurology, Child & Adolescent Psychiatry
- Hours beyond a day in 83 months, but with up to 10152 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99214 ($136 per patient-month) sit in the top 5% of every provider billing that code.
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, even counting one unit per claim line | 179.7 | 206.3 | 137.6 | 184.8 | 4802 | 1 | 90791 90792 90834 90846 90847 99212 99213 99214 T1016 | $419K |
| Feb 2018 | More hours than a day holds, even counting one unit per claim line | 194.9 | 233.5 | 155.7 | 217.3 | 4897 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 T1016 | $428K |
| Mar 2018 | More hours than a day holds, even counting one unit per claim line | 227.2 | 271.3 | 180.9 | 254.4 | 5784 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 T1016 | $545K |
| Apr 2018 | More hours than a day holds, even counting one unit per claim line | 252.0 | 259.5 | 173.0 | 246.8 | 5760 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 T1016 | $501K |
| May 2018 | More hours than a day holds, even counting one unit per claim line | 247.4 | 256.7 | 171.1 | 230.2 | 6215 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 T1016 | $518K |
| Jun 2018 | More hours than a day holds, even counting one unit per claim line | 237.5 | 262.2 | 174.8 | 249.2 | 5919 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 T1016 | $503K |
| Jul 2018 | More hours than a day holds, even counting one unit per claim line | 214.2 | 244.3 | 162.9 | 229.2 | 5787 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 99223 99232 99238 T1016 | $480K |
| Aug 2018 | More hours than a day holds, even counting one unit per claim line | 218.2 | 311.8 | 207.9 | 279.5 | 6219 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 T1016 | $621K |
| Sep 2018 | More hours than a day holds, even counting one unit per claim line | 202.3 | 286.0 | 190.6 | 284.9 | 5895 | 1 | 90791 90792 90834 90846 90847 90853 99212 99213 99214 T1016 | $549K |
| Oct 2018 | More hours than a day holds, even counting one unit per claim line | 235.4 | 357.4 | 238.3 | 320.0 | 6669 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $702K |
| Nov 2018 | More hours than a day holds, even counting one unit per claim line | 199.9 | 287.3 | 191.5 | 259.8 | 5797 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $545K |
| Dec 2018 | More hours than a day holds, even counting one unit per claim line | 174.1 | 329.7 | 219.8 | 323.3 | 5514 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $648K |
| Jan 2019 | More hours than a day holds, even counting one unit per claim line | 235.5 | 373.9 | 249.3 | 334.7 | 6193 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $848K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 256.0 | 452.9 | 301.9 | 421.6 | 6475 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $925K |
| Mar 2019 | More hours than a day holds, even counting one unit per claim line | 249.4 | 426.2 | 284.1 | 418.3 | 6904 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $949K |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 272.9 | 450.1 | 300.0 | 408.2 | 7133 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $966K |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 263.3 | 438.0 | 292.0 | 392.8 | 7329 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $975K |
| Jun 2019 | More hours than a day holds, even counting one unit per claim line | 252.7 | 419.6 | 279.7 | 418.4 | 6921 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $896K |
| Jul 2019 | More hours than a day holds, even counting one unit per claim line | 273.6 | 454.4 | 302.9 | 407.2 | 7391 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $1.0M |
| Aug 2019 | More hours than a day holds, even counting one unit per claim line | 260.1 | 422.2 | 281.5 | 395.4 | 7357 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $936K |
| Sep 2019 | More hours than a day holds, even counting one unit per claim line | 251.2 | 415.1 | 276.7 | 394.2 | 7022 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $897K |
| Oct 2019 | More hours than a day holds, even counting one unit per claim line | 272.7 | 454.8 | 303.2 | 407.5 | 7513 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $1.0M |
| Nov 2019 | More hours than a day holds, even counting one unit per claim line | 233.2 | 385.5 | 257.0 | 366.1 | 6627 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $827K |
| Dec 2019 | More hours than a day holds, even counting one unit per claim line | 212.1 | 345.8 | 230.6 | 323.8 | 6353 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $769K |
| Jan 2020 | More hours than a day holds, even counting one unit per claim line | 263.4 | 428.9 | 285.9 | 384.6 | 7550 | 1 | 90791 90792 90834 90846 90847 90853 99213 99214 T1016 | $1.0M |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 253.9 | 412.4 | 274.9 | 397.9 | 7090 | 1 | 90791 90792 90832 90834 90846 90847 90853 99213 99214 T1016 | $919K |
| Mar 2020 | More hours than a day holds, even counting one unit per claim line | 269.8 | 432.4 | 288.2 | 405.4 | 7705 | 1 | 90791 90792 90832 90834 90846 90847 90853 99213 99214 T1016 | $1.0M |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 355.0 | 581.3 | 387.5 | 527.8 | 8572 | 1 | 90791 90792 90832 90834 90846 90847 90853 99213 99214 T1016 | $1.3M |
| May 2020 | More hours than a day holds, even counting one unit per claim line | 311.9 | 526.7 | 351.1 | 517.8 | 8026 | 1 | 90791 90792 90832 90834 90846 90847 90853 99212 99213 99214 T1016 | $1.3M |
| Jun 2020 | More hours than a day holds, even counting one unit per claim line | 342.6 | 580.1 | 386.7 | 526.7 | 8495 | 1 | 90791 90792 90832 90834 90846 90847 90853 99212 99213 99214 T1016 | $1.3M |
| Jul 2020 | More hours than a day holds, even counting one unit per claim line | 351.8 | 547.9 | 365.3 | 492.0 | 8904 | 1 | 90791 90792 90832 90834 90846 90847 90853 99212 99213 99214 T1016 | $1.3M |
| Aug 2020 | More hours than a day holds, even counting one unit per claim line | 327.0 | 645.3 | 430.2 | 634.1 | 9126 | 1 | 90791 90792 90832 90834 90846 90847 90853 99212 99213 99214 T1016 | $1.6M |
| Sep 2020 | More hours than a day holds, even counting one unit per claim line | 371.4 | 712.1 | 474.7 | 646.4 | 8957 | 1 | 90791 90792 90832 90834 90846 90847 90853 99212 99213 99214 T1016 | $1.7M |
| Oct 2020 | More hours than a day holds, even counting one unit per claim line | 318.0 | 632.1 | 421.4 | 592.6 | 9030 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99212 99213 99214 T1016 | $1.5M |
| Nov 2020 | More hours than a day holds, even counting one unit per claim line | 308.8 | 616.6 | 411.1 | 586.0 | 8896 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99212 99213 99214 T1016 | $1.4M |
| Dec 2020 | More hours than a day holds, even counting one unit per claim line | 298.6 | 610.8 | 407.2 | 547.6 | 8989 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99212 99213 99214 T1016 | $1.5M |
| Jan 2021 | More hours than a day holds, even counting one unit per claim line | 332.7 | 640.1 | 426.7 | 628.9 | 9595 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99212 99213 99214 T1016 | $1.7M |
| Feb 2021 | More hours than a day holds, even counting one unit per claim line | 356.9 | 676.6 | 451.1 | 630.4 | 9244 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 99215 T1016 | $1.6M |
| Mar 2021 | More hours than a day holds, even counting one unit per claim line | 314.5 | 604.6 | 403.0 | 541.7 | 9535 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.6M |
| Apr 2021 | More hours than a day holds, even counting one unit per claim line | 329.5 | 667.8 | 445.2 | 605.8 | 10101 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.7M |
| May 2021 | More hours than a day holds, even counting one unit per claim line | 290.8 | 594.0 | 396.0 | 582.7 | 9565 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.6M |
| Jun 2021 | More hours than a day holds, even counting one unit per claim line | 320.3 | 663.8 | 442.6 | 601.9 | 9983 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.7M |
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 282.5 | 568.8 | 379.2 | 533.0 | 9177 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.5M |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 284.4 | 602.9 | 402.0 | 565.3 | 8786 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.6M |
| Sep 2021 | More hours than a day holds, even counting one unit per claim line | 300.5 | 637.4 | 424.9 | 578.0 | 8724 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.6M |
| Oct 2021 | More hours than a day holds, even counting one unit per claim line | 288.7 | 611.2 | 407.4 | 599.7 | 8784 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.6M |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 298.5 | 642.2 | 428.1 | 582.4 | 8523 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.6M |
| Dec 2021 | More hours than a day holds, even counting one unit per claim line | 267.1 | 578.8 | 385.9 | 519.2 | 7923 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 96130 99213 99214 T1016 | $1.5M |
| Jan 2022 | More hours than a day holds, even counting one unit per claim line | 329.4 | 668.9 | 445.9 | 656.6 | 9074 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.7M |
| Feb 2022 | More hours than a day holds, even counting one unit per claim line | 342.6 | 705.6 | 470.4 | 657.1 | 8818 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99204 99213 99214 T1016 | $1.6M |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 364.8 | 822.3 | 548.2 | 737.7 | 10152 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99204 99213 99214 T1016 | $2.0M |
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 330.9 | 714.1 | 476.1 | 679.0 | 9370 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.7M |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 303.4 | 697.0 | 464.6 | 653.5 | 9268 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.7M |
| Jun 2022 | More hours than a day holds, even counting one unit per claim line | 295.5 | 701.2 | 467.5 | 636.2 | 8965 | 1 | 90791 90792 90832 90834 90837 90846 90847 90853 99204 99213 99214 99223 99238 T1016 | $1.7M |
| Jul 2022 | More hours than a day holds, even counting one unit per claim line | 233.3 | 563.9 | 375.9 | 553.7 | 8106 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.4M |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 233.6 | 611.6 | 407.7 | 548.3 | 7786 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.5M |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 220.5 | 592.2 | 394.8 | 537.3 | 7235 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.4M |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 212.2 | 555.0 | 370.0 | 545.0 | 7150 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.4M |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 215.4 | 581.5 | 387.6 | 527.4 | 7053 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 99215 T1016 | $1.4M |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 172.1 | 468.0 | 312.0 | 438.6 | 6037 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.1M |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 201.7 | 548.6 | 365.8 | 514.6 | 6990 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.3M |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 213.4 | 602.5 | 401.6 | 561.4 | 6580 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.3M |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 200.6 | 556.1 | 370.7 | 499.1 | 6687 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.3M |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 182.9 | 510.9 | 340.6 | 510.4 | 6107 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.1M |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 200.9 | 554.2 | 369.4 | 497.9 | 6669 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 | $1.3M |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 185.5 | 512.8 | 341.9 | 465.8 | 5807 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $1.1M |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 144.4 | 401.3 | 267.6 | 394.5 | 4827 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $905K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 183.0 | 498.1 | 332.1 | 446.4 | 5590 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99204 99213 99214 T1016 | $1.1M |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 155.7 | 438.1 | 292.1 | 416.5 | 4616 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $954K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 144.3 | 405.1 | 270.1 | 379.8 | 4639 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $911K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 129.8 | 363.0 | 242.0 | 329.4 | 3973 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 T1016 | $778K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 96.6 | 266.9 | 177.9 | 262.0 | 3242 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 T1016 | $591K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 106.3 | 242.9 | 162.0 | 217.8 | 3351 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 T1016 | $638K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 112.3 | 253.7 | 169.2 | 233.6 | 3352 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 | $627K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 92.3 | 217.2 | 144.8 | 213.6 | 2946 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 T1016 | $565K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 95.3 | 225.4 | 150.3 | 204.5 | 2966 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 T1016 | $569K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 87.4 | 211.5 | 141.0 | 189.7 | 2839 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 T1016 | $552K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 75.9 | 180.1 | 120.1 | 180.1 | 2503 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 | $455K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 77.6 | 173.4 | 115.6 | 155.8 | 2608 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 | $453K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 74.6 | 162.2 | 108.1 | 151.1 | 2473 | 2 | 90791 90792 90832 90834 90837 90847 90853 99213 99214 H0038 | $423K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 67.2 | 150.9 | 100.6 | 142.5 | 2241 | 2 | 90791 90832 90834 90837 90846 90847 90853 99213 99214 H0038 | $382K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 81.7 | 182.8 | 121.9 | 162.7 | 2647 | 2 | 90791 90792 90832 90834 90837 90846 90847 90853 99213 99214 H0038 | $478K |
| Nov 2024 | More hours than a day holds, even counting one unit per claim line | 55.5 | 128.6 | 85.7 | 122.4 | 1911 | 2 | 90791 90832 90834 90837 90846 90847 90853 99213 99214 | $325K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | KISHORE K SRIRAM, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | August 13, 2007, last updated August 29, 2012 |
| Practice location | 850 N HARRISON ST, Warsaw, IN 46580-3163, 574-267-7169 |
| Specialties | Student in an Organized Health Care Education/Training Program (390200000X, license 2007016061 MO) Psychiatry & Neurology, Child & Adolescent Psychiatry (2084P0804X, primary, license 01070060A IN) |
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 | |
|---|---|---|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | $41.0M | 45% | $204 | $101 (top 5% from $318) | 85th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $12.4M | 14% | $136 | $60 (top 5% from $133) | 95th percentile | |
| 90832 | Psychotherapy, 30 minutes | $11.3M | 12% | $196 | $59 (top 5% from $239) | 93rd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $7.3M | 8% | $113 | $44 (top 5% from $110) | 95th percentile | |
| 90791 | Psychiatric diagnostic evaluation | $6.1M | 7% | $121 | $105 (top 5% from $228) | 67th percentile | |
| 90853 | Group psychotherapyhistory of abuse | $3.8M | 4% | $168 | $60 (top 5% from $332) | 87th percentile | |
| 90792 | Psychiatric diagnostic evaluation with medical services | $2.9M | 3% | $140 | $112 (top 5% from $313) | 67th percentile | |
| 90847 | Family psychotherapy with patient, 50 minutes | $2.0M | 2% | $85 | $130 (top 5% from $458) | 22nd percentile |
| 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 | 42 | 13 | $2K | $95 | $70 | 1.4x | 2.6x (90th percentile 4.3x) |
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
3 providers in Kosciusko County, IN carry an indicator in the public record, with $407.3M at stake between them. The most common is more hours than a day holds, on 3 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 4 | RICHARD RUHROLD Warsaw, IN, ranked 7548 | $314.1M |
|
| 4 | HESTER LIEBETRAU Warsaw, IN, ranked 7846 | $92.9M |
|
| 4 | JOEY GRAHAM Warsaw, IN, ranked 8256 | $260K |
|
Recent enforcement in IN
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.