Providers
All 15 in TX
VAHID MIRAFZALI, M.D.
NPI 1851457691, individual, Brownsville, TX, Pediatrics
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 12 months, but with up to 3070 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 99051 ($42 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7750, $1.5M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Apr 2022 | More hours than a day holds, even counting one unit per claim line | 25.5 | 15.0 | 10.0 | 14.3 | 2141 | 2 | 99202 99203 99211 99212 99213 | $50K |
| May 2022 | More hours than a day holds, even counting one unit per claim line | 25.8 | 15.7 | 10.5 | 14.7 | 2240 | 2 | 99202 99203 99211 99212 99213 | $55K |
| Aug 2022 | More hours than a day holds, even counting one unit per claim line | 24.1 | 15.5 | 10.3 | 13.9 | 2158 | 2 | 99203 99211 99212 99213 | $54K |
| Sep 2022 | More hours than a day holds, even counting one unit per claim line | 35.1 | 20.6 | 13.7 | 18.7 | 2801 | 2 | 99202 99203 99211 99212 99213 | $69K |
| Oct 2022 | More hours than a day holds, even counting one unit per claim line | 39.2 | 22.4 | 15.0 | 22.1 | 3070 | 2 | 99203 99212 99213 99214 | $76K |
| Nov 2022 | More hours than a day holds, even counting one unit per claim line | 29.5 | 17.4 | 11.6 | 15.8 | 2398 | 2 | 99202 99203 99211 99212 99213 | $58K |
| Dec 2022 | More hours than a day holds, even counting one unit per claim line | 24.3 | 14.3 | 9.5 | 13.4 | 2089 | 2 | 99202 99203 99211 99212 99213 | $49K |
| Feb 2023 | More hours than a day holds, even counting one unit per claim line | 26.2 | 14.8 | 9.9 | 13.9 | 2055 | 2 | 99203 99211 99212 99213 | $48K |
| Apr 2023 | More hours than a day holds, even counting one unit per claim line | 25.3 | 14.8 | 9.9 | 14.8 | 2253 | 2 | 99202 99203 99211 99212 99213 | $52K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 25.9 | 15.6 | 10.4 | 14.0 | 2293 | 2 | 99202 99203 99211 99212 99213 99214 | $56K |
| Oct 2023 | More hours than a day holds, even counting one unit per claim line | 25.3 | 15.6 | 10.4 | 14.7 | 2191 | 2 | 99203 99211 99212 99213 | $55K |
| Nov 2023 | More hours than a day holds, even counting one unit per claim line | 24.1 | 15.8 | 10.5 | 14.3 | 2076 | 2 | 99212 99213 | $53K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | VAHID MIRAFZALI, M.D. |
| Type | Individual, sole proprietor |
| Status | Active |
| NPI issued | December 28, 2006, last updated April 23, 2013 |
| Practice location | 5850 FM 802, SUITE C 6-7, Brownsville, TX 78526-5203, 956-831-0880 |
| Mailing address | 5850 FM 802 STE C6-7, Brownsville, TX 78526-5203 |
| Specialties | Pediatrics (208000000X, primary, license K6156 TX) |
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 | |
|---|---|---|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $1.7M | 27% | $29 | $44 (top 5% from $110) | 27th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $1.3M | 22% | $41 | $32 (top 5% from $49) | 78th percentile | |
| 99051 | Medicaid service code | $904K | 15% | $42 | $6.71 (top 5% from $30) | 97th percentile | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $556K | 9% | $19 | $22 (top 5% from $33) | 39th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $228K | 4% | $14 | $28 (top 5% from $147) | 27th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $189K | 3% | $54 | $67 (top 5% from $121) | 29th percentile | |
| 99393 | Medicaid service code | $188K | 3% | $82 | $78 (top 5% from $121) | 59th percentile | |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | $180K | 3% | $8.21 | $12 (top 5% from $18) | 27th percentile |
In this area
15 providers in Cameron County, TX carry an indicator in the public record, with $10.2M at stake between them. The most common is more hours than a day holds, on 9 of them, followed by part of a provider network on 5. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | SOUTHWEST MEDICAL HOMEPATIENT Harlingen, TX, ranked 665 | $0 |
|
| 3 | EMPIRE SPANISH MEADOWS LTD Brownsville, TX, ranked 1638 | $2K |
|
| 3 | K&M HOSPICE LLC Rio Hondo, TX, ranked 3914 | $0 |
|
| 3 | WILLOW HOSPICE CARE LLC Rio Hondo, TX, ranked 4074 | $0 |
|
| 3 | APC HOME HEALTH SERVICE, INC Harlingen, TX, ranked 5596 | $0 |
|
| 3 | THE MEDICAL TEAM INC Harlingen, TX, ranked 5853 | $0 |
|
| 4 | ASIM ZAMIR Brownsville, TX, ranked 7408 | $6.9M |
|
| 4 | FRANCISCO TORRES Brownsville, TX, ranked 7814 | $1.1M |
|
Recent enforcement in TX
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementAug 26, 2026
Dallas medical clinic to pay $7.5 million to resolve COVID-19 testing overbilling allegations
Aymancare billed the federal government's HRSA Uninsured Program for separate evaluation and management services in addition to COVID-19 specimen collection and testing at pop-up testing sites when no such separate services were performed.
DOJConvictedAug 12, 2026
Scammer pharmacist guilty in $20 million healthcare kickback scheme
Thomas paid over $2 million in kickbacks to the owner of a Houston clinic in exchange for referrals of DOL-OWCP insured patients prescribed high-reimbursement compounded medications, which his pharmacy then billed to DOL-OWCP, receiving more than $20 million in reimbursements.
DOJIndictedJun 24, 2026
U.S. Attorney Announces Major Health Care Fraud Cases in Western District of Texas
Charles is alleged to have received illegal kickbacks for referring patients to San Antonio area hospice companies, causing over $9 million in Medicare claims, while Dr. Duncan settled allegations of billing Medicare and TRICARE for an unapproved amniotic-based product and Trevor's Place settled allegations of submitting inflated TRICARE claims for services not provided.
DOJIndictedJun 23, 2026
Nine charged in SDTX as part of national health care fraud takedown
Nine defendants were indicted in the Southern District of Texas for operating pill mill clinics and a pharmacy that unlawfully distributed controlled substances, billing Medicaid $16 million for mental health services for minors that did not occur, and billing Medicare and TRICARE approximately $906 million for medically unnecessary amniotic wound allografts procured through kickbacks.
DOJChargedJun 23, 2026
Northern District of Texas Charges 13 Health Care Fraudsters for Loss Over $360 Million
Thirteen defendants in the Northern District of Texas were charged in seven cases involving more than $365 million in fraudulent billing to federally-funded programs and other insurers, including laboratory and genetic testing claims procured through kickbacks, transcranial magnetic stimulation treatments billed to TRICARE, medically unnecessary EEG testing, and hospice services never provided.
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.