Providers
All 11 in CA
SVETLANA MOORE, M.D.
NPI 1750678553, individual, Yuba City, CA, Family Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 5 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99213 ($687 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7895, $719K at stake
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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2019 | More hours than a day holds at a conservative unit price | 5.5 | 55.2 | 36.8 | 51.5 | 327 | 1 | 99203 99212 99213 99214 | $65K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 6.3 | 70.4 | 46.9 | 69.3 | 372 | 1 | 99203 99212 99213 99214 | $91K |
| Apr 2019 | More hours than a day holds at a conservative unit price | 5.7 | 53.1 | 35.4 | 48.2 | 347 | 1 | 99203 99212 99213 99214 | $67K |
| May 2019 | More hours than a day holds at a conservative unit price | 5.0 | 44.2 | 29.5 | 39.7 | 321 | 1 | 99203 99212 99213 99214 | $56K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 1.4 | 40.4 | 27.0 | 40.4 | 93 | 1 | 99212 99213 99214 | $50K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SVETLANA MOORE, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | June 30, 2011, last updated November 11, 2024 |
| Practice location | 1590 POOLE BLVD, Yuba City, CA 95993-2607, 530-751-1800 |
| Mailing address | PO BOX 255228, Sacramento, CA 95865-5228 |
| Specialties | Family Medicine (207Q00000X, primary, license A129688 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 | |
|---|---|---|---|---|---|---|---|
| T1015 | Medicaid service code | $1.9M | 71% | $687 | $182 (top 5% from $488) | 97th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $598K | 22% | $189 | $44 (top 5% from $110) | 98th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $84K | 3% | $177 | $60 (top 5% from $133) | 98th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $41K | 2% | $124 | $28 (top 5% from $147) | 94th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $33K | 1% | $103 | $67 (top 5% from $121) | 89th percentile | |
| 81002 | Urinalysis, manual test | $8K | 0% | $100 | $2.15 (top 5% from $4.65) | too few months to rank | |
| 99173 | Medicaid service code | $5K | 0% | $96 | $1.22 (top 5% from $11) | too few months to rank | |
| 99392 | Medicaid service code | $3K | 0% | $37 | $78 (top 5% from $124) | too few months to rank |
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 |
|---|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | 35 | 27 | $4K | $357 | $130 | 2.7x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 37 | 31 | $3K | $243 | $93 | 2.6x | 2.2x (90th percentile 3.8x) |
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 Sutter County, CA carry an indicator in the public record, with $1.8M at stake between them. The most common is part of a provider network, on 8 of them, followed by more hours than a day holds on 3.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Yuba City, CA, ranked 870 | $6K |
|
| 3 | NIGHTINGALE HOME HEALTHCARE OF NORTHERN CALIFORNIA INC. Yuba City, CA, ranked 1235 | $279K |
|
| 3 | WESTERN HEALTH RESOURCES Yuba City, CA, ranked 1334 | $125K |
|
| 3 | GUAVA HOLDINGS LLC Yuba City, CA, ranked 1846 | $0 |
|
| 3 | WESTERN HEALTH RESOURCES Yuba City, CA, ranked 3614 | $0 |
|
| 3 | UNITED COM-SERVE Yuba City, CA, ranked 4723 | $0 |
|
| 3 | SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Yuba City, CA, ranked 6687 | $0 |
|
| 3 | FLAX HOLDINGS, LLC Live Oak, CA, ranked 7088 | $0 |
|
Recent enforcement in CA
All releasesDepartment 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.