Providers
All 15 in OH
RACHAEL MARIE SMITH
NPI 1740758804, individual, Middletown, OH, Nurse Practitioner, Family
5
Evidence tier
informational
- Medicaid dollars per patient on code 99214 ($243 per patient-month) sit in the top 5% of every provider billing that code.
score 35 of 100, rank 9958, $2.2M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RACHAEL MARIE SMITH |
| Type | Individual |
| Status | Active |
| NPI issued | November 7, 2018, last updated August 19, 2021 |
| Practice location | 1036 S VERITY PKWY, Middletown, OH 45044-5513, 513-454-1111 |
| Mailing address | 300 HIGH ST FL 4, Hamilton, OH 45011-6078 |
| Specialties | Nurse Practitioner, Family (363LF0000X, primary, license aprn.cnp.023913 OH) |
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 | $1.4M | 43% | $243 | $60 (top 5% from $133) | 99th percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $613K | 19% | $111 | $49 (top 5% from $109) | 95th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $601K | 19% | $81 | $44 (top 5% from $110) | 89th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $130K | 4% | $55 | $45 (top 5% from $110) | 64th percentile | |
| H0048 | Medicaid service code | $89K | 3% | $30 | $23 (top 5% from $57) | 73rd percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $77K | 2% | $66 | $67 (top 5% from $121) | 49th percentile | |
| T1015 | Medicaid service code | $67K | 2% | $105 | $182 (top 5% from $488) | 23rd percentile | |
| 82075 | Measurement of alcohol level in breath specimen | $67K | 2% | $39 | $29 (top 5% from $75) | 72nd percentile |
In this area
15 providers in Butler County, OH carry an indicator in the public record, with $17.9M at stake between them. The most common is part of a provider network, on 6 of them, followed by more hours than a day holds on 5. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | LAKKARAJ RAJASEKHAR West Chester, OH, ranked 10 | $226K |
|
| 3 | HEARTS OF CARE HOME HEALTH CARE AGENCY West Chester, OH, ranked 1037 | $1.1M |
|
| 3 | HILLANDALE NURSING CARE, LTD. Hamilton, OH, ranked 2312 | $0 |
|
| 3 | CYNTHIA LANGE Middletown, OH, ranked 2314 | $0 |
|
| 3 | HILLANDALE NURSING CARE, LTD. Hamilton, OH, ranked 2487 | $0 |
|
| 3 | ARLINGTON POINTE INVESTMENT GROUP, LLC Middletown, OH, ranked 2947 | $0 |
|
| 3 | MUSTAFA ISSA West Chester, OH, ranked 3204 | $0 |
|
| 3 | CHESTERWOOD NURSING CARE, LTD. West Chester, OH, ranked 4616 | $0 |
|
Recent enforcement in OH
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Ohio Dentist Agrees to Pay $500,000 to Resolve Allegations of Submitting False Claims to Medicaid
Meckler billed the Ohio Department of Medicaid for services provided by Ball, who was excluded from the Medicaid program, by listing Meckler as the rendering provider instead of Ball.
DOJSentencedJun 15, 2026
Ohio Doctor Ordered to Pay Nearly $1M for Facilitating Fraud on Medicare
A physician working as an independent contractor for a telemedicine company signed doctor's orders for durable medical equipment braces and genetic testing without meaningfully reviewing patient records or performing required in-person assessments, and those orders were used to bill Medicare more than $1,842,524.
DOJCivil settlementApr 2, 2026
Trinity Hospital Agrees to Pay $1.7M to Resolve Alleged Stark Law Violations
Trinity agreed to pay $1.7 million to resolve allegations that from 2014 through 2020 it made improper financial contributions to two referring physicians through office space rental arrangements that exceeded fair market value, in violation of the Stark Law.
DOJComplaint filedFeb 20, 2026
Justice Department Sues OhioHealth for Anticompetitive Healthcare Contracts That Increase Costs for Ohio Patients
The Justice Department and Ohio Attorney General filed a civil antitrust complaint alleging OhioHealth used its market power to impose contractual restrictions that prevent insurers from offering lower-cost health plans and limit access to price information.
DOJSentencedJan 14, 2026
Ohio Doctor Sentenced to Prison for $14M Healthcare Fraud Scheme
A licensed Ohio physician employed by two Florida telemedicine companies signed pre-completed orders for durable medical equipment and cancer genetic testing, falsely affirming he had examined the patients, causing more than $14.5 million in fraudulent Medicare claims.
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.