Providers
All 47 in CA
JUAN E POSADA MD INCORPORATED
NPI 1851590780, organization, San Jose, CA, Family Medicine, Adult Medicine
1
Evidence tier
documented action, then payment
- Listed on the Medicare revocation list since January 27, 2021.
- Medicaid still paid claims in 10 later months, $1,835 in total.
score 93 of 100, rank 371, $2K at stake
Public list actions
Medicare revocation effective January 27, 2021, barred from re-enrolling until January 27, 2031
424.535(a)(9) failure to report and 424.535(a)(3) felonies, Part B Supplier - Clinic/Group Practice, CA
Paid after the action
Months in which Medicaid paid claims for this provider after a public action that should have triggered a screening check. This is a record of payments, not a determination that they were improper.
| list | identity check | action date | window closed | months paid after | first | last | paid after | 12 months before |
|---|---|---|---|---|---|---|---|---|
| Medicare revocation list 424.535(a)(9) failure to report and 424.535(a)(3) felonies | Exact NPI, name verified | Jan 27, 2021 | Jan 27, 2031 | 10 | Feb 2021 | Nov 2021 | $2K | $1K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JUAN E POSADA MD INCORPORATED (also JUAN E POSADA MD INCORPORATED) |
| Type | Organization |
| Status | Active |
| NPI issued | July 11, 2007, last updated June 18, 2015 |
| Practice location | 200 JOSE FIGUERES AVE, STE #485-495, San Jose, CA 95116-1585, 408-259-3022 |
| Authorized official | Juan Posada (M.d) |
| Specialties | Family Medicine, Adult Medicine (207QA0505X, primary, license A54533 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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $2K | 44% | $0.42 | $60 (top 5% from $133) | too few months to rank | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $679 | 17% | $0.29 | $44 (top 5% from $110) | too few months to rank | |
| 99395 | Medicaid service code | $619 | 15% | $6.01 | $73 (top 5% from $138) | too few months to rank | |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | $541 | 13% | $0.76 | $11 (top 5% from $25) | too few months to rank | |
| 99385 | Medicaid service code | $412 | 10% | $34 | $74 (top 5% from $146) | too few months to rank | |
| 82962 | Blood glucose (sugar) test performed by hand-held instrument | $32 | 1% | $0.04 | $1.54 (top 5% from $9.17) | too few months to rank | |
| 81002 | Urinalysis, manual test | $0 | 0% | $0.00 | $2.15 (top 5% from $4.65) | too few months to rank | |
| 99396 | Medicaid service code | $0 | 0% | $0.00 | $70 (top 5% from $132) | too few months to rank |
In this area
47 providers in Santa Clara County, CA carry an indicator in the public record, with $42.6M at stake between them. The most common is part of a provider network, on 24 of them, followed by more hours than a day holds on 21. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | BRENDA VILLASENOR East Palo Alto, CA, ranked 385 | $1K |
|
| 3 | PROHEALTH HOME CARE, INC. San Jose, CA, ranked 1317 | $137K |
|
| 3 | SUTTER VISITING NURSE ASSOCIATION AND HOSPICE Saratoga, CA, ranked 1464 | $30K |
|
| 3 | COMFORT HANDS HEALTHCARE INC San Jose, CA, ranked 1568 | $7K |
|
| 3 | GOLD STAR HOSPICE LLC Sunnyvale, CA, ranked 1848 | $0 |
|
| 3 | FIVE STAR HOME CARE LLC Sunnyvale, CA, ranked 1872 | $0 |
|
| 3 | HELENIUM HOME HEALTH INC San Jose, CA, ranked 2341 | $0 |
|
| 3 | CAMDEN POSTACUTE CARE, INC. Campbell, CA, ranked 2935 | $0 |
|
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.