Providers
All 11 in IL
VISHNU MADIREDDY, M.D.
NPI 1811063761, individual, Riverwoods, IL, Internal Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 52 months, but with up to 1260 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99395 ($140 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7612, $2.6M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2018 | More hours than a day holds at a conservative unit price | 23.1 | 72.0 | 48.0 | 64.7 | 1140 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $42K |
| Feb 2018 | More hours than a day holds at a conservative unit price | 22.8 | 69.0 | 46.0 | 64.4 | 1083 | 1 | 99203 99204 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $36K |
| Mar 2018 | More hours than a day holds at a conservative unit price | 21.3 | 66.4 | 44.2 | 62.3 | 1069 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $38K |
| Apr 2018 | More hours than a day holds at a conservative unit price | 17.1 | 59.5 | 39.7 | 56.7 | 890 | 1 | 99212 99213 99214 99305 99308 99309 | $35K |
| May 2018 | More hours than a day holds at a conservative unit price | 13.2 | 46.8 | 31.2 | 42.1 | 737 | 1 | 99212 99213 99214 99305 99308 99309 | $30K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 12.5 | 39.8 | 26.6 | 37.9 | 691 | 1 | 99203 99212 99213 99214 99305 99308 99309 | $25K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 14.0 | 42.5 | 28.3 | 39.9 | 761 | 1 | 99203 99212 99213 99214 99222 99232 99305 99308 99309 | $27K |
| Nov 2018 | More hours than a day holds at a conservative unit price | 17.2 | 53.5 | 35.7 | 48.7 | 634 | 1 | 99203 99213 99214 99222 99232 99233 99239 99305 99309 | $29K |
| Dec 2018 | More hours than a day holds at a conservative unit price | 20.4 | 59.8 | 39.9 | 58.9 | 1047 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $38K |
| Jan 2019 | More hours than a day holds at a conservative unit price | 23.3 | 87.6 | 58.4 | 78.7 | 1204 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $44K |
| Feb 2019 | More hours than a day holds at a conservative unit price | 21.5 | 72.4 | 48.3 | 67.6 | 1026 | 1 | 99203 99212 99213 99214 99233 99239 99305 99308 99309 | $36K |
| Mar 2019 | More hours than a day holds at a conservative unit price | 19.3 | 68.7 | 45.8 | 67.6 | 936 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $38K |
| Apr 2019 | More hours than a day holds, even counting one unit per claim line | 28.1 | 96.9 | 64.6 | 88.1 | 1225 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $50K |
| May 2019 | More hours than a day holds, even counting one unit per claim line | 24.4 | 78.4 | 52.3 | 70.5 | 1177 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $45K |
| Jun 2019 | More hours than a day holds at a conservative unit price | 22.0 | 71.2 | 47.5 | 71.2 | 1059 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $42K |
| Jul 2019 | More hours than a day holds at a conservative unit price | 21.1 | 66.1 | 44.1 | 59.4 | 978 | 1 | 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $31K |
| Aug 2019 | More hours than a day holds at a conservative unit price | 11.9 | 39.6 | 26.4 | 37.2 | 584 | 1 | 99212 99213 99214 99232 99233 99239 99305 99309 | $22K |
| Sep 2019 | More hours than a day holds at a conservative unit price | 13.7 | 49.9 | 33.2 | 47.5 | 718 | 1 | 99212 99213 99214 99232 99233 99305 99308 99309 | $25K |
| Oct 2019 | More hours than a day holds at a conservative unit price | 14.7 | 50.7 | 33.8 | 45.6 | 750 | 1 | 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $27K |
| Nov 2019 | More hours than a day holds at a conservative unit price | 14.3 | 42.0 | 28.0 | 40.0 | 708 | 1 | 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $24K |
| Dec 2019 | More hours than a day holds at a conservative unit price | 16.0 | 48.9 | 32.6 | 45.9 | 923 | 1 | 99203 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $39K |
| Jan 2020 | More hours than a day holds at a conservative unit price | 21.9 | 68.6 | 45.7 | 61.7 | 1044 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $45K |
| Feb 2020 | More hours than a day holds, even counting one unit per claim line | 26.1 | 74.8 | 49.9 | 72.3 | 1220 | 1 | 99203 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $48K |
| Mar 2020 | More hours than a day holds at a conservative unit price | 18.0 | 47.5 | 31.7 | 44.6 | 1148 | 1 | 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $40K |
| Apr 2020 | More hours than a day holds, even counting one unit per claim line | 25.9 | 61.5 | 41.0 | 55.9 | 952 | 1 | 99213 99214 99222 99232 99233 99239 99291 99305 99309 | $40K |
| Jun 2020 | More hours than a day holds at a conservative unit price | 16.9 | 47.4 | 31.6 | 43.1 | 751 | 1 | 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $35K |
| Jul 2020 | More hours than a day holds, even counting one unit per claim line | 27.4 | 96.9 | 64.6 | 87.0 | 1055 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $78K |
| Aug 2020 | More hours than a day holds, even counting one unit per claim line | 31.0 | 132.9 | 88.6 | 130.8 | 944 | 1 | 99203 99213 99214 99222 99232 99233 99239 99305 99308 99309 | $83K |
| Sep 2020 | More hours than a day holds, even counting one unit per claim line | 31.9 | 155.1 | 103.4 | 141.0 | 935 | 1 | 99203 99213 99214 99222 99232 99233 99239 99305 99309 | $79K |
| Oct 2020 | More hours than a day holds, even counting one unit per claim line | 24.1 | 126.0 | 84.0 | 118.3 | 917 | 1 | 99213 99214 99222 99232 99233 99239 99305 99309 | $70K |
| Nov 2020 | More hours than a day holds at a conservative unit price | 20.9 | 112.5 | 75.0 | 107.1 | 812 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $57K |
| Dec 2020 | More hours than a day holds, even counting one unit per claim line | 25.1 | 146.7 | 97.8 | 131.9 | 935 | 1 | 99212 99213 99214 99222 99232 99233 99239 99309 | $69K |
| Jan 2021 | More hours than a day holds at a conservative unit price | 21.0 | 89.2 | 59.4 | 87.7 | 963 | 1 | 99203 99212 99213 99214 99232 99233 99239 99305 99309 | $70K |
| Feb 2021 | More hours than a day holds at a conservative unit price | 18.7 | 59.4 | 39.6 | 55.4 | 808 | 1 | 99212 99213 99214 99222 99232 99233 99239 99309 | $49K |
| Mar 2021 | More hours than a day holds at a conservative unit price | 15.0 | 46.7 | 31.1 | 41.9 | 816 | 1 | 99212 99213 99214 99232 99233 99305 99309 | $48K |
| Apr 2021 | More hours than a day holds at a conservative unit price | 21.3 | 53.8 | 35.9 | 48.9 | 1080 | 1 | 99202 99203 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $55K |
| May 2021 | More hours than a day holds at a conservative unit price | 20.8 | 53.4 | 35.6 | 52.6 | 1076 | 1 | 99203 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $55K |
| Jun 2021 | More hours than a day holds at a conservative unit price | 19.5 | 51.8 | 34.6 | 47.1 | 970 | 1 | 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $49K |
| Jul 2021 | More hours than a day holds at a conservative unit price | 16.1 | 48.6 | 32.4 | 45.7 | 844 | 1 | 99212 99213 99214 99305 99309 | $44K |
| Aug 2021 | More hours than a day holds at a conservative unit price | 16.7 | 36.9 | 24.6 | 34.7 | 897 | 1 | 99212 99213 99214 99222 99232 99233 99239 99305 99309 | $42K |
| Sep 2021 | More hours than a day holds at a conservative unit price | 16.8 | 38.6 | 25.7 | 35.1 | 857 | 1 | 99213 99214 99222 99232 99233 99239 99305 99309 | $39K |
| Oct 2021 | More hours than a day holds at a conservative unit price | 22.9 | 54.4 | 36.3 | 53.5 | 1191 | 1 | 99213 99214 99222 99232 99233 99239 99305 99309 | $52K |
| Nov 2021 | More hours than a day holds, even counting one unit per claim line | 28.3 | 71.2 | 47.5 | 64.8 | 1260 | 1 | 99213 99214 99232 99233 99239 99305 99309 | $60K |
| Dec 2021 | More hours than a day holds at a conservative unit price | 22.9 | 56.2 | 37.4 | 50.5 | 1074 | 1 | 99213 99214 99222 99232 99233 99239 99305 99309 | $53K |
| Jan 2022 | More hours than a day holds at a conservative unit price | 22.2 | 73.8 | 49.2 | 72.6 | 1075 | 1 | 99213 99214 99222 99232 99233 99239 99305 99309 | $62K |
| Feb 2022 | More hours than a day holds at a conservative unit price | 19.4 | 48.2 | 32.1 | 45.0 | 930 | 1 | 99213 99214 99222 99232 99233 99239 99305 99307 99308 99309 | $41K |
| Mar 2022 | More hours than a day holds, even counting one unit per claim line | 26.3 | 65.5 | 43.7 | 58.9 | 1204 | 1 | 99213 99214 99222 99232 99233 99239 99305 99307 99308 99309 | $61K |
| Apr 2022 | More hours than a day holds at a conservative unit price | 14.2 | 38.5 | 25.7 | 36.7 | 785 | 1 | 99213 99214 99305 99307 99308 99309 | $40K |
| May 2022 | More hours than a day holds at a conservative unit price | 23.3 | 59.4 | 39.6 | 55.8 | 1042 | 1 | 99213 99214 99222 99232 99233 99239 99305 99307 99308 99309 99310 | $50K |
| Jun 2022 | More hours than a day holds at a conservative unit price | 18.9 | 51.7 | 34.5 | 47.0 | 874 | 1 | 99213 99214 99222 99232 99233 99239 99305 99307 99309 | $42K |
| Sep 2022 | More hours than a day holds at a conservative unit price | 13.2 | 38.0 | 25.3 | 34.5 | 713 | 1 | 99213 99214 99215 99233 99305 99308 99309 | $34K |
| Oct 2022 | More hours than a day holds at a conservative unit price | 12.1 | 36.7 | 24.5 | 36.1 | 636 | 1 | 99213 99214 99232 99233 99305 99307 99309 | $26K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | VISHNU MADIREDDY, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | November 24, 2006, last updated March 8, 2023 |
| Practice location | 1105 MILWAUKEE AVE, Riverwoods, IL 60015-3512, 847-325-5110 |
| Specialties | Internal Medicine (207R00000X, primary, license 036091869 IL) Internal Medicine (207R00000X, license MD61327419 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 | |
|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $1.2M | 38% | $37 | $21 (top 5% from $84) | 78th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $758K | 25% | $98 | $60 (top 5% from $133) | 84th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $365K | 12% | $58 | $44 (top 5% from $110) | 69th percentile | |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $107K | 3% | $93 | $96 (top 5% from $249) | 48th percentile | |
| 99395 | Medicaid service code | $71K | 2% | $140 | $73 (top 5% from $138) | 95th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $58K | 2% | $11 | $14 (top 5% from $58) | 37th percentile | |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | $57K | 2% | $43 | $22 (top 5% from $71) | 83rd percentile | |
| 99315 | Nursing facility discharge day management, 30 minutes or less | $49K | 2% | $31 | $22 (top 5% from $55) | 77th 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 |
|---|---|---|---|---|---|---|---|---|
| 99424 | Principal care management services for a single high-risk disease, first 30 minutes provided personally by qualified health care professional, per calendar month. | 3,368 | 373 | $186K | $120 | $71 | 1.7x | 2.1x (90th percentile 4.2x) |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 676 | 387 | $53K | $218 | $103 | 2.1x | 2.0x (90th percentile 3.3x) |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 222 | 60 | $20K | $140 | $114 | 1.2x | 2.6x (90th percentile 4.7x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 219 | 199 | $12K | $454 | $71 | 6.4x | 2.0x (90th percentile 3.4x) |
| 99291 | Critical care, first 30-74 minutes | 60 | 15 | $10K | $295 | $207 | 1.4x | 4.7x (90th percentile 10.0x) |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 66 | 61 | $8K | $936 | $146 | 6.4x | 2.0x (90th percentile 3.4x) |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 108 | 52 | $6K | $96 | $75 | 1.3x | 2.6x (90th percentile 4.3x) |
| 99496 | Transitional care management services for problem of high complexity | 51 | 48 | $6K | $350 | $182 | 1.9x | 1.9x (90th percentile 3.1x) |
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 Lake County, IL carry an indicator in the public record, with $15.2M at stake between them. The most common is more hours than a day holds, on 5 of them, followed by part of a provider network on 4. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | KRISHNASWAMI SRIRAM Lake Forest, IL, ranked 486 | $0 |
|
| 3 | ALIYA OF HIGHWOOD LLC Highwood, IL, ranked 3036 | $0 |
|
| 3 | ATNT HOME HEALTH CARE INC. Deerfield, IL, ranked 4806 | $0 |
|
| 3 | PAVILION OF WAUKEGAN, LLC Waukegan, IL, ranked 6370 | $0 |
|
| 3 | CEDAR HILLS HEALTH & REHAB, LLC Zion, IL, ranked 6435 | $0 |
|
| 4 | JENNIFER BELLUCCI JACKSON Wauconda, IL, ranked 7370 | $10.8M |
|
| 4 | DAVID ALENGO Wauconda, IL, ranked 7621 | $2.5M |
|
| 5 | SACHIN JAIN Waukegan, IL, ranked 10083 | $1.1M |
|
Recent enforcement in IL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 23, 2026
United States Attorney Andrew S. Boutros Announces Charges Against Two Chicago-Area Defendants as Part of Department of Justice’s National Healthcare Fraud Takedown
Two Chicago-area defendants were charged, one for selling Medicare beneficiary information and providing fake AI-generated consent recordings so laboratories could bill Medicare for over-the-counter Covid-19 test kits that were never requested or provided, and the other for directing the creation of fake medical records and billing Illinois Medicaid for behavioral health counseling and therapy services that were never provided, including for deceased beneficiaries.
DOJConvictedJun 18, 2026
Suburban Chicago Chiropractor Convicted of Healthcare Fraud
A chiropractor submitted fraudulent claims to Blue Cross Blue Shield of Illinois for health care services that were not actually provided and submitted false patient medical records when the insurer attempted to audit the claims.
DOJSentencedJun 10, 2026
Jacksonville Chiropractor Sentenced to a Year in Prison for Healthcare Fraud and Related Offenses
Rondeau submitted more than 2,000 fraudulent claims to health insurance companies and convinced clients to sign false documents after learning he was under investigation.
DOJCivil settlementMay 8, 2026
Three Affiliated Skilled Nursing Facilities to Pay $300,000 to Resolve False Claims Act Allegations Related to Medically Unnecessary Rehabilitation Services
Three affiliated skilled nursing facilities billed Medicare between Jan. 1, 2014, and Sept. 30, 2019, for physical therapy, occupational therapy, and speech pathology services provided to patients for longer than medically necessary and without regard for patients' individual medical needs, resulting in claims based on inflated RUG levels.
DOJIndictedFeb 12, 2026
Two Foreign Nationals Indicted in Chicago as Part of $10 Million Health Care Fraud Scheme
The indictment alleges the defendants used nominee-owned laboratories and durable medical equipment providers to submit fraudulent claims to Medicare and private health care benefit programs for items and services that were not provided, and laundered and transferred proceeds to Pakistan.
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.