Providers

DAPHINE KANIARU, MD

NPI 1902287089, individual, Lemoore, CA, Family Medicine

4
Evidence tier
structure or single-organization volume
  • Hours beyond a day in 1 month, but with up to 3104 patients a month across 4 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
score 48 of 100, rank 9763, $3K 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.

monthwhat was foundhours per day, lower boundhours per day, at pricehours per day, conservativeper working daypatientsbilling organizationscodespaid
Aug 2021More hours than a day holds, even counting one unit per claim line33.42.61.72.43104399202 99203 99212 99213 99214$3K

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameDAPHINE KANIARU, MD
TypeIndividual
StatusActive
NPI issuedJune 15, 2015, last updated April 9, 2024
Practice location140 C ST, Lemoore, CA 93245-2929, 559-925-6000
Mailing addressPO BOX 580, Lemoore, CA 93245-0580
Specialties
Family Medicine (207Q00000X, primary, license A139320 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
T1015Medicaid service code$9.8M98%$215$182 (top 5% from $488)63rd percentile
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$88K1%$1.86$44 (top 5% from $110)6th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$21K0%$7.34$60 (top 5% from $133)6th percentile
0012AIntramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; second dose$13K0%$43$35 (top 5% from $67)too few months to rank
0011AIntramuscular administration of single severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, mrna-lnp, spike protein, preservative free, 100 mcg/0.5ml dosage; first dose$12K0%$36$29 (top 5% from $65)too few months to rank
99212Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$8K0%$0.51$28 (top 5% from $147)10th percentile
87635Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen$4K0%$0.63$44 (top 5% from $70)3rd percentile
99203New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more$3K0%$1.73$67 (top 5% from $121)3rd percentile

In this area

4 providers in Kings County, CA carry an indicator in the public record, with $398K at stake between them. The most common is part of a provider network, on 2 of them, followed by more hours than a day holds on 2.

tierproviderat stakewhy
3WESTERN HEALTH RESOURCES
Hanford, CA, ranked 1255
$251K
  • Part of provider network D1-00071, ranked 71 nationally.
3WESTERN HEALTH RESOURCES
Hanford, CA, ranked 1907
$0
  • Part of provider network D1-00071, ranked 71 nationally.
4XIN LING LAO
Hanford, CA, ranked 9773
$873
  • Hours beyond a day in 2 months, but with up to 973 patients a month across 3 billing organizations, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.
5ELTON TRIPP
Hanford, CA, ranked 11541
$146K

Recent enforcement in CA

All releases

Department 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

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