KARTHIK RAMAKRISHNAN, MD

NPI 1942248943, individual, Beckley, WV, Internal Medicine

Evidence tier

structure or single-organization volume

Hours beyond a day in 1 month under one organization, which can be supervisory billing.
Records needed.

score 50 of 100, rank 9533, $137K 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	11.4	38.5	25.7	34.6	389	2	99213 99214 99223 99232 99233 99239 99306 99308 99309 99310	$29K

National provider registry

From the CMS NPPES Registry, refreshed daily.

Name	KARTHIK RAMAKRISHNAN, MD
Type	Individual
Status	Active
NPI issued	June 2, 2006, last updated December 12, 2017
Practice location	1710 HARPER RD, Beckley, WV 25801-3357, 304-256-4100
Mailing address	1761 PARK AVE SW, Norton, VA 24273-1608
Specialties	Internal Medicine (207R00000X, primary, license MD40088 TN)

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	$151K	33%	$48	$44 (top 5% from $110)	57th percentile
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	$76K	17%	$73	$60 (top 5% from $133)	64th percentile
99233	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes	$61K	13%	$167	$96 (top 5% from $249)	83rd percentile
99223	Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes	$46K	10%	$108	$81 (top 5% from $170)	72nd percentile
99232	Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	$38K	8%	$108	$67 (top 5% from $174)	80th percentile
99309	Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes	$26K	6%	$20	$21 (top 5% from $84)	48th percentile
99239	Hospital discharge day management, more than 30 minutes	$25K	5%	$71	$49 (top 5% from $101)	77th percentile
99310	Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes	$18K	4%	$22	$30 (top 5% from $134)	37th 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
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	64	26	$4K	$175	$120	1.5x	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

4 providers in Raleigh County, WV carry an indicator in the public record, with $4.1M at stake between them. The most common is more hours than a day holds, on 3 of them, followed by named in an enforcement record on 1.

tier	provider	at stake	why
3	WEST VIRGINIA SLEEP CENTERS Beckley, WV, ranked 6406	$0	Charged (complaint) per a Department of Justice release dated June 23, 2026, not adjudicated.
4	DONNA MURRAY Beckley, WV, ranked 8203	$758K	Hours beyond a day in 1 month, but with up to 577 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed. and 1 more
4	HASSAN JAFARY Beckley, WV, ranked 8749	$1.9M	Hours beyond a day in 18 months, but with up to 1035 patients a month, which points to a supervising clinician on the claims rather than one person's hours. Records needed.
5	MUSTAFA RAHIM Beckley, WV, ranked 10919	$1.4M

Recent enforcement in WV

All releases

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

DOJCivil settlementJun 23, 2026

Northern District of West Virginia Part of National Health Care Fraud Takedown Resulting in 455 Defendants Charged in Connection with Over $6.5 Billion in Alleged Fraud

Two providers reached civil settlements resolving allegations that they used pre-signed, invalid prescriptions issued outside the usual course of their professional practice to patients in West Virginia while traveling and not in close proximity to their offices, and in one case submitted claims to Medicare and Medicaid during that time.

DOJComplaint filedJun 23, 2026

U.S. Attorney Moore Capito Announces Fraud Conspiracy Charges Against Sober Living Home Founder and Spouse

Two individuals affiliated with a sober living recovery program allegedly conspired to falsify and submit timesheets to a testing laboratory for drug testing work not performed, and the laboratory paid the billings and obtained reimbursement from federal and state healthcare programs; separately, a sleep laboratory paid $120,000 to resolve allegations it billed Medicaid and the VA Community Health program for sleep studies and polysomnogram reports prepared and signed by unqualified, non-physician staff.

DOJPleaded guiltyJun 17, 2026

Mercer County Woman Pleads Guilty to $175,731.31 Fraud Scheme Targeting Federal Veterans Health Care Benefits

Radford, an owner of Healthcare Therapy Services LLC doing business as Medical Massage Therapy, submitted false bills to CHAMPVA for massage services not rendered, stealing $175,731.31.

DOJCivil settlementMar 5, 2026

Laboratory Agrees to Pay More than $200,000 for Improper Billing to West Virginia Medicaid Program

Integra repeatedly submitted billings to the West Virginia Medicaid program for medically unnecessary testing ordered by medical providers over a two-year period, specifically improper claims for specimen validity testing that were not allowable.

DOJCivil settlementApr 2, 2025

Beckley Medical Clinic and Physician Agree to Pay $152,382.70 to Resolve False Claims Act Allegations

Med-Surg and its owner submitted claims to Medicare and Medicaid using HCPCS code Q3014 for the telehealth originating site facility fee for telehealth visits where the patient was at home, which is not payable.

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.

Ask this case

Answers come only from the evidence tables, and every sentence cites the record it used.