Providers

KARTHIKEYA DEVIREDDY, MD

NPI 1780615542, individual, Los Banos, CA, Internal Medicine

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 80 months, but with up to 4201 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 52 of 100, rank 8509, $3.4M 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Jan 2018More hours than a day holds, even counting one unit per claim line36.712.58.311.22508399203 99213 99214 99222 99223 99232 99238$20K
Feb 2018More hours than a day holds, even counting one unit per claim line35.19.36.28.72282399203 99213 99214 99223 99238 99309$14K
Mar 2018More hours than a day holds, even counting one unit per claim line35.69.36.28.72476399203 99213 99214 99223 99309$15K
Apr 2018More hours than a day holds, even counting one unit per claim line29.27.55.07.11920399203 99213 99214 99223 99309 G0447$12K
May 2018More hours than a day holds, even counting one unit per claim line28.18.35.57.41893399203 99213 99214 99223 99232 99238 99309$13K
Jun 2018More hours than a day holds, even counting one unit per claim line26.77.04.76.71744399203 99213 99214 99223 99232 99309$10K
Jul 2018More hours than a day holds, even counting one unit per claim line27.69.16.18.61817499203 99213 99214 99222 99223 99232 99309$15K
Aug 2018More hours than a day holds, even counting one unit per claim line33.918.112.116.32249499203 99213 99214 99223 99232 99239 99309$29K
Sep 2018More hours than a day holds, even counting one unit per claim line32.421.114.121.12178499203 99213 99214 99223 99232 99239 99309$33K
Oct 2018More hours than a day holds, even counting one unit per claim line34.921.114.119.02460499203 99213 99214 99223 99309$33K
Nov 2018More hours than a day holds, even counting one unit per claim line35.923.115.421.02395499203 99213 99214 99223 99232 99309$35K
Dec 2018More hours than a day holds, even counting one unit per claim line35.222.114.721.72378499203 99213 99214 99215 99223 99232 99306 99335$36K
Jan 2019More hours than a day holds, even counting one unit per claim line39.128.919.326.02583499203 99204 99211 99213 99214 99223 99232 99306 99335$45K
Feb 2019More hours than a day holds, even counting one unit per claim line39.431.320.929.22541499203 99213 99214 99223 99232 99306$41K
Mar 2019More hours than a day holds, even counting one unit per claim line34.627.518.327.12522499203 99213 99214 99222 99223 99232$37K
Apr 2019More hours than a day holds, even counting one unit per claim line35.828.719.126.12483499203 99213 99214 99222 99223$38K
May 2019More hours than a day holds, even counting one unit per claim line34.426.417.623.72280499203 99213 99214 99222 99223 99232$35K
Jun 2019More hours than a day holds, even counting one unit per claim line28.323.715.823.71841499203 99213 99214 99223$32K
Jul 2019More hours than a day holds, even counting one unit per claim line27.120.213.518.11765499203 99204 99213 99214 99222 99223 99232 99238$30K
Aug 2019More hours than a day holds, even counting one unit per claim line45.724.316.222.92054499203 99213 99214 99222 99223 99232$36K
Sep 2019More hours than a day holds, even counting one unit per claim line51.026.017.324.72173499203 99213 99214 99223$35K
Oct 2019More hours than a day holds, even counting one unit per claim line51.727.318.224.62403499203 99211 99213 99214 99222 99223 99232$39K
Nov 2019More hours than a day holds, even counting one unit per claim line49.324.316.223.22195499203 99211 99213 99214 99308$34K
Dec 2019More hours than a day holds, even counting one unit per claim line56.424.116.122.72283399203 99211 99213 99214$38K
Jan 2020More hours than a day holds, even counting one unit per claim line62.431.020.727.92507499203 99211 99213 99214 99308$47K
Feb 2020More hours than a day holds, even counting one unit per claim line69.733.122.132.02593499203 99211 99213 99214 99308$48K
Mar 2020More hours than a day holds, even counting one unit per claim line50.426.017.324.42225499203 99211 99212 99213 99214 99308$36K
Apr 2020More hours than a day holds, even counting one unit per claim line36.916.911.315.41412499203 99213 99214 99308 99442$24K
May 2020More hours than a day holds, even counting one unit per claim line40.621.214.120.81684499203 99213 99214 99222 99232 99308 99442$31K
Jun 2020More hours than a day holds, even counting one unit per claim line48.723.515.621.31935499203 99211 99212 99213 99214 99442$35K
Jul 2020More hours than a day holds, even counting one unit per claim line54.527.118.024.32392499203 99211 99212 99213 99214 99442$41K
Aug 2020More hours than a day holds, even counting one unit per claim line53.926.417.626.02238499203 99211 99212 99213 99214 99222 99442$43K
Sep 2020More hours than a day holds, even counting one unit per claim line54.426.617.724.22059499203 99211 99212 99213 99214$43K
Oct 2020More hours than a day holds, even counting one unit per claim line36.325.116.823.62159499211 99212 99213 99214 99222 G0447$42K
Nov 2020More hours than a day holds, even counting one unit per claim line51.925.316.924.12250499203 99211 99212 99213 99214$41K
Dec 2020More hours than a day holds, even counting one unit per claim line68.730.120.127.12673499203 99204 99211 99212 99213 99214 99222$50K
Jan 2021More hours than a day holds, even counting one unit per claim line67.333.922.633.32831499203 99204 99211 99212 99213 99214 99222 99232 99308 99442 G0447$56K
Feb 2021More hours than a day holds, even counting one unit per claim line69.929.719.827.72445499203 99211 99212 99213 99214 99308$45K
Mar 2021More hours than a day holds, even counting one unit per claim line77.430.720.427.62844499202 99203 99204 99211 99212 99213 99214 99308 G0447$53K
Apr 2021More hours than a day holds, even counting one unit per claim line79.631.621.128.82885499203 99204 99211 99212 99213 99214$51K
May 2021More hours than a day holds, even counting one unit per claim line63.727.218.226.82485499203 99211 99212 99213 99214 99222 G0447$44K
Jun 2021More hours than a day holds, even counting one unit per claim line65.324.016.021.82438499203 99211 99212 99213 99214$37K
Jul 2021More hours than a day holds, even counting one unit per claim line61.523.015.421.62354499203 99211 99212 99213 99214$38K
Aug 2021More hours than a day holds, even counting one unit per claim line84.536.924.634.63337499203 99211 99212 99213 99214$66K
Sep 2021More hours than a day holds, even counting one unit per claim line92.039.326.235.83537499203 99211 99212 99213 99214$69K
Oct 2021More hours than a day holds, even counting one unit per claim line79.930.820.530.33061499203 99211 99212 99213 99214$53K
Nov 2021More hours than a day holds, even counting one unit per claim line76.533.522.330.42781499203 99211 99213 99214 99222 99232$54K
Dec 2021More hours than a day holds, even counting one unit per claim line72.727.018.024.32757499203 99211 99213 99214$48K
Jan 2022More hours than a day holds, even counting one unit per claim line105.350.833.850.04201499203 99204 99211 99213 99214 99309 99442$89K
Feb 2022More hours than a day holds, even counting one unit per claim line74.331.821.229.72637499203 99204 99211 99213 99214 99308 99309$47K
Mar 2022More hours than a day holds, even counting one unit per claim line60.332.621.729.32810499203 99211 99213 99214 99309$50K
Apr 2022More hours than a day holds, even counting one unit per claim line39.226.517.725.22263499203 99211 99212 99213 99214 99309$37K
May 2022More hours than a day holds, even counting one unit per claim line35.030.920.629.12339499203 99212 99213 99214 99308$44K
Jun 2022More hours than a day holds, even counting one unit per claim line32.829.519.726.82267499203 99212 99213 99214 99308$40K
Jul 2022More hours than a day holds, even counting one unit per claim line29.026.617.726.22023499203 99213 99214 99308$36K
Aug 2022More hours than a day holds, even counting one unit per claim line35.928.218.825.32546499203 99213 99214 99308$37K
Sep 2022More hours than a day holds, even counting one unit per claim line35.229.119.426.52452499203 99212 99213 99214 99308$37K
Oct 2022More hours than a day holds, even counting one unit per claim line33.251.634.450.82349499203 99212 99213 99214 99308$65K
Nov 2022More hours than a day holds, even counting one unit per claim line59.173.148.866.52669499203 99212 99213 99214 99308$86K
Dec 2022More hours than a day holds, even counting one unit per claim line63.664.843.260.92483499203 99212 99213 99214 99308$81K
Jan 2023More hours than a day holds, even counting one unit per claim line52.762.641.758.82049499203 99213 99214 99308$71K
Feb 2023More hours than a day holds, even counting one unit per claim line61.271.347.566.52165499203 99213 99214 99308$73K
Mar 2023More hours than a day holds, even counting one unit per claim line54.461.240.855.02179499203 99212 99213 99214 99308$68K
Apr 2023More hours than a day holds, even counting one unit per claim line51.259.239.559.21993499203 99212 99213 99214 99308$64K
May 2023More hours than a day holds, even counting one unit per claim line50.356.837.951.11978499203 99212 99213 99214 99308$64K
Jun 2023More hours than a day holds, even counting one unit per claim line45.748.332.243.91724399203 99212 99213 99214$54K
Jul 2023More hours than a day holds, even counting one unit per claim line42.145.130.144.41645499203 99213 99214 99308$52K
Aug 2023More hours than a day holds, even counting one unit per claim line48.953.035.347.61927499203 99213 99214 99308$59K
Sep 2023More hours than a day holds, even counting one unit per claim line46.150.933.948.41758499203 99213 99214 99308 99309$55K
Oct 2023More hours than a day holds, even counting one unit per claim line27.947.131.444.21694499203 99213 99214 99309$52K
Nov 2023More hours than a day holds, even counting one unit per claim line48.056.837.951.61848499203 99213 99214 99309$59K
Dec 2023More hours than a day holds, even counting one unit per claim line47.055.537.054.61863499203 99213 99214 99309$58K
Jan 2024More hours than a day holds, even counting one unit per claim line29.535.823.932.21752399203 99204 99212 99213 99214 G0447$36K
Feb 2024More hours than a day holds, even counting one unit per claim line25.71.71.21.61559399203 99204 99213 99214$2K
Apr 2024More hours than a day holds, even counting one unit per claim line31.53.02.02.71885499203 99204 99213 99214 99309 G0447$3K
May 2024More hours than a day holds, even counting one unit per claim line33.13.12.12.82061499203 99204 99213 99214 99309 G0447$3K
Aug 2024More hours than a day holds, even counting one unit per claim line32.619.713.118.51778499203 99212 99213 99214 99309$23K
Sep 2024More hours than a day holds, even counting one unit per claim line38.438.525.736.71482399203 99213 99214 99309$44K
Oct 2024More hours than a day holds, even counting one unit per claim line25.714.79.813.21360299203 99211 99213 99214 99309$18K
Nov 2024More hours than a day holds, even counting one unit per claim line30.976.050.672.31286199213 99214$90K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameKARTHIKEYA DEVIREDDY, MD
TypeIndividual, sole proprietor
StatusActive
NPI issuedJuly 6, 2006, last updated January 22, 2020
Practice location311 W I ST, Los Banos, CA 93635-3479, 209-826-2222
Mailing address311 WEST I STREET, Los Banos, CA 93635
Specialties
Internal Medicine (207R00000X, primary, license A35184 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
T1015Medicaid service code$12.8M57%$80$182 (top 5% from $488)17th percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$1.7M7%$14$44 (top 5% from $110)13th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$1.4M6%$26$60 (top 5% from $133)13th percentile
0241URespiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected$1.2M5%$135$113 (top 5% from $189)66th percentile
99394Medicaid service code$375K2%$73$83 (top 5% from $128)41st percentile
99393Medicaid service code$288K1%$57$78 (top 5% from $121)29th percentile
95144Professional service for preparation and provision of single-dose vial of allergen$283K1%$1K$181 (top 5% from $2K)94th percentile
87502Detection test by nucleic acid for multiple types influenza virus$244K1%$72$71 (top 5% from $112)51st percentile
Medicare Part B 2024, largest codes
codewhat it isservicesbeneficiariespaidsubmitted per serviceallowed per servicecharge to allowedusual for this code
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes667133$58K$150$1091.4x2.0x (90th percentile 3.3x)
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more48195$29K$125$751.7x2.0x (90th percentile 3.4x)
90673Influenza vaccine, trivalent derived from recombinant dna195191$16K$125$821.5x1.0x (90th percentile 1.5x)
0241URespiratory infectious agent detection by rna for severe acute respiratory syndrome coronavirus 2 (covid 19), influenza a, influenza b, and respiratory syncytial virus, upper respiratory specimen, each reported as detected or not detected9892$14K$215$1401.5x2.0x (90th percentile 3.2x)
82306Vitamin d-3 level400389$12K$50$291.7x2.9x (90th percentile 5.3x)
84443Blood test, thyroid stimulating hormone (tsh)589558$10K$30$161.8x3.3x (90th percentile 5.5x)
80061Blood test, lipids (cholesterol and triglycerides)609569$8K$30$132.3x3.5x (90th percentile 6.9x)
36415Insertion of needle into vein for collection of blood sample917728$8K$15$91.7x2.0x (90th percentile 3.5x)

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

23 providers in Merced County, CA carry an indicator in the public record, with $26.8M at stake between them. The most common is more hours than a day holds, on 20 of them, followed by part of a provider network on 2. 1 is tier 1: documented action, then payment.

tierproviderat stakewhy
1RODOLFO GARCIA
Los Banos, CA, ranked 425
$288
  • Listed on the CA Medicaid exclusion list since May 10, 2019.
  • Medicaid still paid claims in 1 later month, $288 in total.
3BRISTOL HOSPICE - CALIFORNIA, LLC
Merced, CA, ranked 1211
$338K
  • Part of provider network D1-00104, ranked 104 nationally.
3AVALON CARE CENTER-MERCED FRANCISCAN LLC
Merced, CA, ranked 4649
$0
  • Part of provider network D1-00104, ranked 104 nationally.
4MIRANDA FURIE
Merced, CA, ranked 7284
$7.6M
  • Hours beyond a day in 30 months, but with up to 742 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 2 more
4PRIYANKA JAIN
Merced, CA, ranked 7905
$634K
  • Hours beyond a day in 2 months, but with up to 506 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4ABHILASHA SHARMA
Merced, CA, ranked 7961
$423K
  • Hours beyond a day in 26 months, but with up to 4678 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
  • and 1 more
4GEORGE ALKHOURI
Merced, CA, ranked 8725
$2.0M
  • Hours beyond a day in 23 months, but with up to 1649 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
4ELLEN PIERNOT
Merced, CA, ranked 8971
$1.0M
  • Hours beyond a day in 46 months, but with up to 9907 patients a month across 17 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
All 23 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.