Providers
RANDALL CHARLES BERINHOUT, M.D.
NPI 1720031503, individual, Stockbridge, GA, Pain Medicine, Interventional Pain Medicine
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since March 1, 2024.
- Medicaid still paid claims in 4 later months, $95 in total.
- Medicare submitted charges on code 80307 are 5.8 times the typical charge-to-allowed ratio for that code.
score 94 of 100, rank 292, $95 at stake
Public list actions
Medicare revocation effective March 1, 2024, barred from re-enrolling until March 1, 2034
424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion), Practitioner - Pain Management, GA
OIG exclusion June 19, 2025 under section 1128a1
Physician (MD, DO), Pain Management, Stockbridge, GA
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 |
|---|---|---|---|---|---|---|---|---|
| Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies and 424.535(a)(2) provider or supplier conduct (exclusion) | Exact NPI, name verified | Mar 1, 2024 | Mar 1, 2034 | 4 | Apr 2024 | Jul 2024 | $95 | $2K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RANDALL CHARLES BERINHOUT, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | May 19, 2006, last updated January 24, 2013 |
| Practice location | 165 N PARK TRL, SUITE 100, Stockbridge, GA 30281-6500, 770-506-1800 |
| Specialties | Pain Medicine, Interventional Pain Medicine (208VP0014X, primary, license 034777 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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $5K | 49% | $6.83 | $60 (top 5% from $133) | 6th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $4K | 40% | $6.52 | $44 (top 5% from $110) | 9th percentile | |
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | $704 | 6% | $19 | $58 (top 5% from $129) | too few months to rank | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $526 | 5% | $20 | $45 (top 5% from $110) | too few months to rank | |
| G8432 | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $0.00) | 0th percentile | |
| 1036F | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $0.00) | 0th percentile | |
| G9903 | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $0.04) | 0th percentile | |
| G8420 | Medicaid service code | $0 | 0% | $0.00 | $0.00 (top 5% from $0.09) | 0th 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 |
|---|---|---|---|---|---|---|---|---|
| G0480 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 98 | 69 | $11K | $1K | $111 | 9.0x | 2.7x (90th percentile 6.1x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 157 | 90 | $10K | $272 | $86 | 3.1x | 2.2x (90th percentile 3.8x) |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 55 | 44 | $5K | $385 | $126 | 3.1x | 2.3x (90th percentile 3.8x) |
| 80307 | Testing for presence of drug, by chemistry analyzers | 69 | 54 | $4K | $1K | $60 | 18.3x | 3.2x (90th percentile 7.6x) |
| G3002 | Chronic pain management and treatment, monthly bundle including, diagnosis; assessment and monitoring; administration of a validated pain rating scale or tool; the development, implementation, revision, and/or maintenance of a person-centered care plan tha | 53 | 42 | $3K | $237 | $81 | 2.9x | 2.3x (90th percentile 4.5x) |
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 20 | 16 | $1K | $535 | $89 | 6.0x | 5.5x (90th percentile 16.3x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 11 | 11 | $1K | $502 | $165 | 3.0x | 2.4x (90th percentile 3.9x) |
| 64494 | Injection of lower or sacral spine facet joint using imaging guidance, second level | 20 | 16 | $791 | $274 | $50 | 5.5x | 5.2x (90th percentile 16.6x) |
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
4 providers in Henry County, GA carry an indicator in the public record, with $210K at stake between them. The most common is paid after a public list action, on 2 of them, followed by named in an enforcement record on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | AMRISH PATEL Mcdonough, GA, ranked 129 | $135K |
|
| 3 | NATIONAL HEALTHCARE CENTER LLC Stockbridge, GA, ranked 6356 | $0 |
|
| 3 | GEORGIA COMMUNITY HOSPICE LLC Stockbridge, GA, ranked 7156 | $0 |
|
| 5 | ALY AHMED Stockbridge, GA, ranked 11683 | $75K |
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.