Providers
PRAKASH VAIDY
NPI 1962486761, individual, Camden, DE, Family Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 12 months under one organization, which can be supervisory billing.
- Records needed.
- Medicaid dollars per patient on code 99213 ($145 per patient-month) sit in the top 5% of every provider billing that code.
score 55 of 100, rank 7924, $540K 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 | 2.4 | 36.6 | 24.4 | 32.9 | 115 | 1 | 99213 | $17K |
| Feb 2018 | More hours than a day holds at a conservative unit price | 2.6 | 39.2 | 26.1 | 36.6 | 120 | 1 | 99213 | $16K |
| Mar 2018 | More hours than a day holds at a conservative unit price | 3.4 | 45.3 | 30.2 | 42.5 | 144 | 2 | 99213 | $21K |
| Apr 2018 | More hours than a day holds at a conservative unit price | 5.8 | 71.2 | 47.5 | 67.8 | 192 | 2 | 99213 | $31K |
| May 2018 | More hours than a day holds at a conservative unit price | 3.3 | 46.1 | 30.7 | 41.4 | 168 | 2 | 99213 | $21K |
| Jun 2018 | More hours than a day holds at a conservative unit price | 3.6 | 54.8 | 36.6 | 52.2 | 150 | 1 | 99213 | $24K |
| Jul 2018 | More hours than a day holds at a conservative unit price | 3.1 | 47.4 | 31.6 | 44.5 | 146 | 1 | 99213 | $22K |
| Aug 2018 | More hours than a day holds at a conservative unit price | 3.8 | 57.1 | 38.1 | 51.3 | 162 | 1 | 99213 | $26K |
| Sep 2018 | More hours than a day holds at a conservative unit price | 4.2 | 63.8 | 42.6 | 63.8 | 180 | 1 | 99213 | $28K |
| Oct 2018 | More hours than a day holds at a conservative unit price | 4.8 | 72.5 | 48.3 | 65.1 | 208 | 1 | 99213 | $33K |
| Nov 2018 | More hours than a day holds at a conservative unit price | 5.8 | 88.0 | 58.6 | 80.0 | 216 | 1 | 99213 | $39K |
| Dec 2018 | More hours than a day holds at a conservative unit price | 3.6 | 54.6 | 36.4 | 53.8 | 173 | 1 | 99213 | $25K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | PRAKASH VAIDY (also PRAKASH VAIDYANATHAN) |
| Type | Individual |
| Status | Active |
| NPI issued | December 5, 2005, last updated March 30, 2021 |
| Practice location | 379 WALMART DR, Camden, DE 19934-1365, 302-387-4343 |
| Mailing address | PO BOX 1040, Elkton, MD 21922-1040 |
| Specialties | Surgery (208600000X, license D0051953 MD) Family Medicine (207Q00000X, primary, license C1-0012808 DE) |
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 | $372K | 37% | $145 | $44 (top 5% from $110) | 97th percentile | |
| 80307 | Testing for presence of drug, by chemistry analyzers | $323K | 32% | $106 | $45 (top 5% from $110) | 94th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $316K | 31% | $187 | $60 (top 5% from $133) | 98th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $3K | 0% | $164 | $67 (top 5% from $121) | too few months to rank | |
| 80299 | Quantitation of therapeutic drug | $0 | 0% | $0.00 | $11 (top 5% from $55) | too few months to rank |
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 |
|---|---|---|---|---|---|---|---|---|
| G0481 | Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms | 241 | 27 | $36K | $200 | $149 | 1.3x | 3.1x (90th percentile 6.1x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 245 | 27 | $15K | $187 | $87 | 2.2x | 2.2x (90th percentile 3.8x) |
| 80307 | Testing for presence of drug, by chemistry analyzers | 244 | 26 | $15K | $250 | $59 | 4.2x | 3.2x (90th percentile 7.6x) |
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
5 providers in Kent County, DE carry an indicator in the public record, with $2.6M at stake between them. The most common is paid after a public list action, on 2 of them, followed by part of a provider network on 1. 2 are tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | EMPIRE MEDICAL LLC Camden, DE, ranked 1 | $2.4M |
|
| 1 | DELAWARE WALK-IN MEDICAL, LLC Camden, DE, ranked 143 | $114K |
|
| 3 | CENTER AT EDEN HILL LLC Dover, DE, ranked 1913 | $0 |
|
| 3 | NIHAR GALA Harrington, DE, ranked 5994 | $0 |
|
| 5 | HIEN NGUYEN Camden, DE, ranked 11696 | $71K |
Recent enforcement in DE
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyJul 2, 2026
South Dakota Man Pleads Guilty to Aggravated Identity Theft and Obtaining Drugs by Fraud
Mauldin used his access as a medical biller and credentialer to steal medical professionals' licensure information to order thousands of opioid pills, falsified his own electronic medical records to pose as a cancer patient and obtain pain management services paid by his private health insurer, and held himself out as a licensed nurse to perform Transcranial Magnetic Stimulation therapy and submit false claims to Medicaid.
DOJComplaint filedJun 30, 2026
Civil Complaint Filed Over False Laboratory Claims
The United States alleges the defendants violated the False Claims Act by submitting thousands of claims to government health care programs for laboratory diagnostic tests that lacked a valid medical purpose, were conducted in violation of laboratory clinical standards, and in numerous cases were not conducted at all.
DOJCivil settlementApr 29, 2026
Former Delaware Physician to Pay $180,000 to Resolve Allegations of Genetic Testing Fraud
A physician agreed to pay $180,000 to resolve False Claims Act allegations that she ordered medically unnecessary genetic tests for more than 100 Medicare beneficiaries with whom she had no established physician-patient relationship, often based only on brief telemedicine consultations or none at all.
DOJIndictedDec 15, 2025
Medical Biller Charged with Diverting Opioids and Federal Health Care Fraud
A medical biller and credentialer used stolen identities and licensure information of medical professionals to order and prescribe himself thousands of opioid pills, falsified his own medical records to obtain pain management treatment paid by a private insurer, and submitted false claims to Medicaid for Transcranial Magnetic Stimulation therapy he performed while posing as a nurse.
DOJComplaint filedJul 7, 2025
United States Files False Claim Act Complaint Against Delaware Medical Provider
The United States alleges that Dr. Mufti referred more than 100 Medicare beneficiaries for medically unnecessary genetic laboratory tests based on brief telemedicine consultations or no consultation, causing false claims to Medicare.
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.