TONI L LADNER, PMHNP-BC

NPI 1922374057, individual, Vicksburg, MS, Nurse Practitioner, Psych/Mental Health

Evidence tier

informational

Medicaid dollars per patient on code 99308 ($121 per patient-month) sit in the top 5% of every provider billing that code.

score 34 of 100, rank 10475, $74K at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	TONI L LADNER, PMHNP-BC
Type	Individual
Status	Active
NPI issued	March 22, 2012, last updated March 30, 2023
Practice location	1911 MISSION 66 STE B, Vicksburg, MS 39180-3762, 601-665-4162
Mailing address	1600 BROAD AVE, Gulfport, MS 39501-3603
Specialties	Psychologist, Prescribing (Medical) (103TP0016X, license r850484 MS) Nurse Practitioner, Psych/Mental Health (363LP0808X, primary, license 850484 MS)

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
99308	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more	$198K	49%	$121	$14 (top 5% from $58)	99th percentile
99336	Domiciliary/rest home visit established level 3 (retired 2023)	$146K	36%	$67	$28 (top 5% from $90)	91st percentile
99335	Domiciliary/rest home visit established level 2 (retired 2023)	$17K	4%	$81	$19 (top 5% from $69)	96th percentile
99309	Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	$11K	3%	$54	$21 (top 5% from $84)	88th percentile
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$8K	2%	$26	$60 (top 5% from $133)	13th percentile
99212	Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	$7K	2%	$140	$28 (top 5% from $147)	too few months to rank
99327	Domiciliary/rest home visit new patient level 4 (retired 2023)	$4K	1%	$54	$92 (top 5% from $147)	too few months to rank
99215	Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or morehistory of abuse	$4K	1%	$17	$88 (top 5% from $210)	7th 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
99309	Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	353	125	$22K	$200	$84	2.4x	2.0x (90th percentile 3.3x)
99349	Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes	279	78	$21K	$240	$99	2.4x	2.0x (90th percentile 3.4x)
90792	Psychiatric diagnostic evaluation with medical services	88	87	$10K	$340	$154	2.2x	2.2x (90th percentile 3.9x)
99348	Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes	104	46	$5K	$144	$60	2.4x	2.1x (90th percentile 3.6x)
99308	Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more	63	25	$3K	$139	$58	2.4x	2.0x (90th percentile 3.4x)
99213	Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more	47	19	$3K	$167	$70	2.4x	2.2x (90th percentile 3.8x)
90832	Psychotherapy, 30 minutes	44	22	$2K	$130	$63	2.1x	2.0x (90th percentile 3.5x)
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	24	12	$2K	$237	$99	2.4x	2.3x (90th percentile 3.8x)

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

52 providers in MS carry an indicator in the public record, with $88.6M at stake between them. The most common is more hours than a day holds, on 31 of them, followed by part of a provider network on 11. 7 are tier 1: documented action, then payment.

tier	provider	at stake	why
1	MILESTONE COMMUNITY DEVELOPMENT CENTER Greenville, MS, ranked 31	$415K	Listed on the Medicare revocation list since February 6, 2023. Medicaid still paid claims in 3 later months, $414,794 in total. and 1 more
1	BRANTLEY NICHOLS Ruleville, MS, ranked 99	$299K	Listed on the Medicare revocation list since July 24, 2018. Medicaid still paid claims in 17 later months, $298,768 in total.
1	CHRISTA STAPLES Columbia, MS, ranked 222	$28K	Listed on the CA Medicaid exclusion list since November 30, 2022. Medicaid still paid claims in 10 later months, $27,901 in total.
1	BENJAMIN SANFORD Starkville, MS, ranked 320	$5K	Listed on the Medicare revocation list since January 26, 2021. Medicaid still paid claims in 3 later months, $5,278 in total.
1	MARION LUND Oxford, MS, ranked 399	$923	Listed on the Medicare revocation list since February 2, 2023. Medicaid still paid claims in 1 later month, $923 in total.
1	FOOT DOCTOR, PLLC Oxford, MS, ranked 400	$923	Listed on the Medicare revocation list since February 2, 2023. Medicaid still paid claims in 1 later month, $923 in total.
1	MEDIHEALTH MEDICAL SOLUTIONS LLC Amory, MS, ranked 512	$0	Adjudicated (sentenced) per a Department of Justice release dated February 15, 2024. No Medicaid payments in the last 12 observed months.
2	JOHN WILKAITIS Jackson, MS, ranked 697	$1.6M	Billed more hands-on hours than a day holds in 2 months, peaking at 24.6 hours per day across 3 billing organizations. Medicaid dollars per patient on code 99232 ($286 per patient-month) sit in the top 5% of every provider billing that code.

All 52 in MS

Recent enforcement in MS

All releases

Department of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.

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