Providers
All 16 in WA
BHUPINDER WALIA, M.D.
NPI 1801039649, individual, Bellevue, WA, Family Medicine
5
Evidence tier
informational
score 30 of 100, rank 11668, $83K at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | BHUPINDER WALIA, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | April 9, 2009, last updated February 14, 2026 |
| Practice location | 11120 NE 33RD PL STE 202, Bellevue, WA 98004-1444, 206-823-1004 |
| Specialties | Family Medicine (207Q00000X, license MD2020-1174 NM) Family Medicine (207Q00000X, primary, license MD60211392 WA) |
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 | |
|---|---|---|---|---|---|---|---|
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | $109K | 41% | $62 | $30 (top 5% from $134) | 80th percentile | |
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | $61K | 23% | $3.80 | $6.11 (top 5% from $38) | 35th percentile | |
| 99358 | Medicaid service code | $22K | 8% | $26 | $18 (top 5% from $94) | 67th percentile | |
| 99491 | Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month | $14K | 5% | $17 | $4.44 (top 5% from $93) | 75th percentile | |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $14K | 5% | $35 | $21 (top 5% from $84) | 75th percentile | |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | $12K | 4% | $43 | $37 (top 5% from $100) | 59th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $5K | 2% | $51 | $67 (top 5% from $174) | 32nd percentile | |
| 99356 | Prolonged service inpatient first hour (retired 2023) | $5K | 2% | $13 | $28 (top 5% from $117) | 26th 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 |
|---|---|---|---|---|---|---|---|---|
| 99490 | Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month | 4,678 | 1,256 | $229K | $117 | $63 | 1.8x | 1.8x (90th percentile 2.9x) |
| 99487 | Complex chronic care management services for two or more chronic conditions, first 60 minutes of clinical staff time directed by health care professional, per calendar month | 1,032 | 601 | $113K | $298 | $138 | 2.2x | 1.6x (90th percentile 2.7x) |
| 99439 | Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month | 2,577 | 1,003 | $97K | $84 | $48 | 1.7x | 1.9x (90th percentile 3.1x) |
| 99489 | Complex chronic care management services for two or more chronic conditions, each additional 60 minutes of clinical staff time directed by health care professional, per calendar month | 201 | 149 | $12K | $145 | $74 | 1.9x | 1.6x (90th percentile 2.8x) |
| 99491 | Chronic care management services for two or more chronic conditions, first 30 minutes provided personally by health care professional, per calendar month | 47 | 40 | $3K | $171 | $84 | 2.0x | 1.8x (90th percentile 2.7x) |
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
16 providers in King County, WA carry an indicator in the public record, with $7.2M at stake between them. The most common is part of a provider network, on 9 of them, followed by more hours than a day holds on 6. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | WILLIAM WASHINGTON Seattle, WA, ranked 621 | $0 |
|
| 3 | COVENANT LIVING WEST Mercer Island, WA, ranked 2295 | $0 |
|
| 3 | EDEN HOME HEALTH OF KING COUNTY, LLC Tukwila, WA, ranked 3042 | $0 |
|
| 3 | HOME HEALTH SEATTLE LLC Federal Way, WA, ranked 3582 | $0 |
|
| 3 | RENTON SNF HEALTHCARE LLC Renton, WA, ranked 4334 | $0 |
|
| 3 | AVALON CARE CENTER - FEDERAL WAY LLC Federal Way, WA, ranked 4360 | $0 |
|
| 3 | CONTINUUM CARE OF KING LLC Tukwila, WA, ranked 5297 | $0 |
|
| 3 | AVALON CARE CENTER-KENT LLC Kent, WA, ranked 5676 | $0 |
|
Recent enforcement in WA
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJSentencedMar 27, 2026
Local Physician Sentenced to 1 Year Imprisonment, a $60,000 fine, and Restitution of $349,272.79 for Adulterating and Misbranding Medical Devices with the Intent to Defraud
Haeger purchased over 500 used and recalled CPAP and BiPAP devices, had the sound abatement foam removed outside clean room conditions, provided the devices to Washington State Medicaid patients through his sleep clinic, and billed Medicaid representing them as new devices in good working order.
DOJCivil settlementJan 12, 2026
DOJ and Seattle-based FidaLab, LLC settle allegations it inflated bills to government health care programs
FidaLab billed Medicare for a series of urinary tract infection tests under multiple billing codes instead of a single code after its request to bill the tests as a panel was denied.
DOJPleaded guiltyDec 18, 2025
Local Physician Pleads Guilty to Adulterating and Misbranding Medical Devices with the Intent to Defraud
Physician purchased over 500 used and recalled CPAP and BiPAP devices, had the sound abatement foam removed outside of clean room conditions, provided the devices to Washington State Medicaid patients, and had staff bill Medicaid representing them as new devices in good working order.
DOJCivil settlementDec 10, 2025
Spokane Physician Pays $120,000 to Resolve Allegations He Prescribed Controlled Substances Without Legitimate Medical Purpose
Between 2017 and 2025 a licensed physician issued over 1,400 prescriptions for controlled substances to thirteen identified patients that lacked legitimate medical purposes or were outside the usual course of professional practice, failing to address red flags of substance abuse.
DOJSentencedDec 2, 2025
Indian national sentenced to prison for Medicare fraud scheme that stole more than $1 million in taxpayer funds
Asif conspired with others to bill Medicare for COVID-19 tests and other respiratory illness tests that had not been ordered or performed through American Labworks LLC.
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.