Providers
All 23 in CA
ABHILASHA SHARMA, MD
NPI 1780998021, individual, Merced, CA, Family Medicine
4
Evidence tier
structure or single-organization volume
- 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.
- Medicaid dollars per patient on code 90677 ($120 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7961, $423K 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 |
|---|---|---|---|---|---|---|---|---|---|
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 26.4 | 7.4 | 5.0 | 7.3 | 2265 | 1 | 99202 99203 99212 99213 99214 | $10K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 25.2 | 8.1 | 5.4 | 7.3 | 2165 | 1 | 99202 99203 99212 99213 99214 | $11K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 24.6 | 7.4 | 4.9 | 7.0 | 2156 | 1 | 99202 99203 99212 99213 99214 99238 | $11K |
| Jan 2023 | More hours than a day holds, even counting one unit per claim line | 27.7 | 6.7 | 4.5 | 6.3 | 2424 | 1 | 99202 99203 99212 99213 99214 | $8K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 31.5 | 8.5 | 5.6 | 7.9 | 2473 | 1 | 99202 99203 99212 99213 99214 | $9K |
| Mar 2023 | More hours than a day holds, even counting one unit per claim line | 32.9 | 8.4 | 5.6 | 7.5 | 2868 | 1 | 99202 99203 99212 99213 99214 99215 | $10K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 29.7 | 8.3 | 5.5 | 8.3 | 2543 | 1 | 99202 99203 99212 99213 99214 | $10K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 30.8 | 8.5 | 5.7 | 7.6 | 2584 | 1 | 99202 99203 99212 99213 99214 99238 | $10K |
| Jun 2023 | More hours than a day holds, even counting one unit per claim line | 43.6 | 18.2 | 12.1 | 16.5 | 3693 | 2 | 99202 99203 99212 99213 99214 99215 99401 | $26K |
| Jul 2023 | More hours than a day holds, even counting one unit per claim line | 37.0 | 17.3 | 11.5 | 17.0 | 3357 | 2 | 99202 99203 99212 99213 99214 99215 99238 99401 | $24K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 44.5 | 20.6 | 13.7 | 18.5 | 3882 | 3 | 99202 99203 99212 99213 99214 99215 99401 | $32K |
| Sep 2023 | More hours than a day holds, even counting one unit per claim line | 47.1 | 25.8 | 17.2 | 24.6 | 4067 | 4 | 99202 99203 99212 99213 99214 99215 99238 | $34K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 42.3 | 23.2 | 15.4 | 21.8 | 3565 | 3 | 99202 99203 99204 99212 99213 99214 99215 | $31K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 55.5 | 28.0 | 18.7 | 25.4 | 4678 | 4 | 99202 99203 99212 99213 99214 99215 | $38K |
| Dec 2023 | More hours than a day holds, even counting one unit per claim line | 47.6 | 23.7 | 15.8 | 23.4 | 4182 | 3 | 99202 99203 99212 99213 99214 99215 | $33K |
| Jan 2024 | More hours than a day holds, even counting one unit per claim line | 48.0 | 17.9 | 12.0 | 16.1 | 3943 | 3 | 99202 99203 99212 99213 99214 99215 99238 | $23K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 51.4 | 8.1 | 5.4 | 7.5 | 3983 | 4 | 99203 99212 99213 99214 99215 | $9K |
| Mar 2024 | More hours than a day holds, even counting one unit per claim line | 40.6 | 3.7 | 2.5 | 3.7 | 3427 | 3 | 99203 99212 99213 99214 99215 | $5K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 43.8 | 4.4 | 2.9 | 4.0 | 3908 | 3 | 99202 99203 99212 99213 99214 99215 | $5K |
| May 2024 | More hours than a day holds, even counting one unit per claim line | 44.8 | 5.7 | 3.8 | 5.1 | 3868 | 2 | 99203 99204 99212 99213 99214 99215 | $7K |
| Jun 2024 | More hours than a day holds, even counting one unit per claim line | 35.3 | 4.2 | 2.8 | 4.2 | 3018 | 2 | 99203 99212 99213 99214 99215 | $5K |
| Jul 2024 | More hours than a day holds, even counting one unit per claim line | 32.8 | 5.4 | 3.6 | 4.8 | 2697 | 2 | 99203 99204 99212 99213 99214 99215 | $6K |
| Aug 2024 | More hours than a day holds, even counting one unit per claim line | 34.5 | 5.9 | 3.9 | 5.6 | 2816 | 2 | 99203 99212 99213 99214 99215 | $8K |
| Sep 2024 | More hours than a day holds, even counting one unit per claim line | 37.7 | 11.2 | 7.4 | 10.6 | 2840 | 3 | 99203 99204 99212 99213 99214 99215 | $18K |
| Oct 2024 | More hours than a day holds, even counting one unit per claim line | 41.1 | 8.8 | 5.8 | 7.9 | 3324 | 3 | 99203 99204 99212 99213 99214 99215 | $13K |
| Nov 2024 | More hours than a day holds, even counting one unit per claim line | 41.3 | 23.0 | 15.3 | 21.9 | 3444 | 2 | 99202 99203 99204 99212 99213 99214 99215 | $27K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ABHILASHA SHARMA, MD |
| Type | Individual |
| Status | Active |
| NPI issued | July 28, 2010, last updated December 5, 2017 |
| Practice location | 847 W CHILDS AVE, Merced, CA 95341-6862, 209-383-7441 |
| Mailing address | 1910 CUSTOMER CARE WAY, Atwater, CA 95301-5167 |
| Specialties | Family Medicine (207Q00000X, license RL11595 ND) Family Medicine (207Q00000X, primary, license A123145 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 | $18.9M | 90% | $191 | $182 (top 5% from $488) | 54th percentile | |
| 59425 | Medicaid service code | $274K | 1% | $119 | $90 (top 5% from $160) | 81st percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $194K | 1% | $2.00 | $44 (top 5% from $110) | 6th percentile | |
| 90677 | Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use | $114K | 1% | $120 | $1.76 (top 5% from $108) | 96th percentile | |
| 99394 | Medicaid service code | $112K | 1% | $47 | $83 (top 5% from $128) | 24th percentile | |
| 99393 | Medicaid service code | $93K | 0% | $37 | $78 (top 5% from $121) | 19th percentile | |
| 99395 | Medicaid service code | $93K | 0% | $21 | $73 (top 5% from $138) | 22nd percentile | |
| 90746 | Hepatitis b vaccine, adult dosage (3 dose schedule) | $91K | 0% | $75 | $45 (top 5% from $75) | 95th 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 |
|---|---|---|---|---|---|---|---|---|
| 83036 | Hemoglobin a1c level | 192 | 169 | $2K | $58 | $10 | 6.1x | 3.5x (90th percentile 6.9x) |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 29 | 28 | $470 | $56 | $16 | 3.5x | 2.6x (90th percentile 4.1x) |
| 81003 | Automated urinalysis test | 165 | 151 | $363 | $18 | $2 | 8.2x | 4.6x (90th percentile 12.7x) |
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | 67 | 63 | $215 | $16 | $3 | 4.9x | 3.7x (90th percentile 8.1x) |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 15 | 15 | $87 | $75 | $15 | 5.0x | 4.2x (90th percentile 7.7x) |
| 85018 | Blood count, hemoglobin | 25 | 24 | $58 | $14 | $2 | 6.0x | 4.4x (90th percentile 10.8x) |
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
23 providers in Merced County, CA carry an indicator in the public record, with $29.7M 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.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | RODOLFO GARCIA Los Banos, CA, ranked 425 | $288 |
|
| 3 | BRISTOL HOSPICE - CALIFORNIA, LLC Merced, CA, ranked 1211 | $338K |
|
| 3 | AVALON CARE CENTER-MERCED FRANCISCAN LLC Merced, CA, ranked 4649 | $0 |
|
| 4 | MIRANDA FURIE Merced, CA, ranked 7284 | $7.6M |
|
| 4 | PRIYANKA JAIN Merced, CA, ranked 7905 | $634K |
|
| 4 | KARTHIKEYA DEVIREDDY Los Banos, CA, ranked 8509 | $3.4M |
|
| 4 | GEORGE ALKHOURI Merced, CA, ranked 8725 | $2.0M |
|
| 4 | ELLEN PIERNOT Merced, CA, ranked 8971 | $1.0M |
|
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.