Providers
SUNIL NAYYAR, M.D.
NPI 1972763852, individual, Westerville, OH, Internal Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 7 months, but with up to 793 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 51 of 100, rank 8915, $1.2M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Sep 2018 | More hours than a day holds, even counting one unit per claim line | 29.6 | 40.4 | 26.9 | 40.4 | 692 | 1 | 90834 99213 99214 99223 99232 99233 99239 99407 | $35K |
| Oct 2018 | More hours than a day holds, even counting one unit per claim line | 29.6 | 44.7 | 29.8 | 40.1 | 793 | 1 | 90834 99205 99213 99214 99215 99223 99232 99233 99239 99407 | $42K |
| Nov 2018 | More hours than a day holds, even counting one unit per claim line | 28.7 | 46.0 | 30.7 | 41.8 | 707 | 1 | 90834 99214 99223 99232 99233 99239 99407 | $39K |
| Dec 2018 | More hours than a day holds, even counting one unit per claim line | 27.9 | 47.2 | 31.5 | 46.4 | 646 | 1 | 90834 99214 99223 99232 99233 99239 99407 | $41K |
| Jan 2019 | More hours than a day holds, even counting one unit per claim line | 28.4 | 41.3 | 27.5 | 37.1 | 718 | 1 | 90834 99214 99223 99232 99233 99239 99407 | $40K |
| Feb 2019 | More hours than a day holds, even counting one unit per claim line | 28.7 | 39.1 | 26.1 | 36.5 | 614 | 1 | 90834 99214 99223 99232 99233 99239 99407 | $33K |
| Jul 2021 | More hours than a day holds, even counting one unit per claim line | 25.1 | 31.1 | 20.8 | 29.3 | 543 | 2 | 90834 99213 99214 99223 99232 99233 99239 | $36K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SUNIL NAYYAR, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | June 13, 2008, last updated January 28, 2013 |
| Practice location | 387 COUNTY LINE RD W STE 225, Westerville, OH 43082-6918, 614-882-4411 |
| Mailing address | 30701 LORAIN RD STE A, North Olmsted, OH 44070-6325 |
| Specialties | Internal Medicine (207R00000X, primary, license 096604 OH) |
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 | |
|---|---|---|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $491K | 34% | $87 | $96 (top 5% from $249) | 43rd percentile | |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $334K | 23% | $65 | $81 (top 5% from $170) | 33rd percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $207K | 14% | $84 | $60 (top 5% from $133) | 74th percentile | |
| 99239 | Hospital discharge day management, more than 30 minutes | $149K | 10% | $35 | $49 (top 5% from $101) | 24th percentile | |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $93K | 6% | $43 | $67 (top 5% from $174) | 22nd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $71K | 5% | $54 | $44 (top 5% from $110) | 64th percentile | |
| 90834 | Psychotherapy, 45 minutes | $25K | 2% | $46 | $101 (top 5% from $318) | 18th percentile | |
| 99407 | Smoking and tobacco use intensive counseling, more than 10 minutes | $18K | 1% | $15 | $14 (top 5% from $36) | 55th 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 | 273 | 23 | $23K | $176 | $110 | 1.6x | 2.3x (90th percentile 3.8x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 159 | 18 | $9K | $125 | $76 | 1.6x | 2.2x (90th percentile 3.8x) |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 53 | 11 | $4K | $214 | $102 | 2.1x | 2.0x (90th percentile 3.3x) |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 14 | 12 | $2K | $365 | $173 | 2.1x | 1.9x (90th percentile 3.1x) |
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
2 providers in Delaware County, OH carry an indicator in the public record, with $1.3M at stake between them. The most common is part of a provider network, on 2 of them.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | EXCEL HEALTH SERVICES LLC Westerville, OH, ranked 1027 | $1.2M |
|
| 3 | EXCEL HOME HEALTH PLUS LLC Delaware, OH, ranked 1519 | $13K |
|
Recent enforcement in OH
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Ohio Dentist Agrees to Pay $500,000 to Resolve Allegations of Submitting False Claims to Medicaid
Meckler billed the Ohio Department of Medicaid for services provided by Ball, who was excluded from the Medicaid program, by listing Meckler as the rendering provider instead of Ball.
DOJSentencedJun 15, 2026
Ohio Doctor Ordered to Pay Nearly $1M for Facilitating Fraud on Medicare
A physician working as an independent contractor for a telemedicine company signed doctor's orders for durable medical equipment braces and genetic testing without meaningfully reviewing patient records or performing required in-person assessments, and those orders were used to bill Medicare more than $1,842,524.
DOJCivil settlementApr 2, 2026
Trinity Hospital Agrees to Pay $1.7M to Resolve Alleged Stark Law Violations
Trinity agreed to pay $1.7 million to resolve allegations that from 2014 through 2020 it made improper financial contributions to two referring physicians through office space rental arrangements that exceeded fair market value, in violation of the Stark Law.
DOJComplaint filedFeb 20, 2026
Justice Department Sues OhioHealth for Anticompetitive Healthcare Contracts That Increase Costs for Ohio Patients
The Justice Department and Ohio Attorney General filed a civil antitrust complaint alleging OhioHealth used its market power to impose contractual restrictions that prevent insurers from offering lower-cost health plans and limit access to price information.
DOJSentencedJan 14, 2026
Ohio Doctor Sentenced to Prison for $14M Healthcare Fraud Scheme
A licensed Ohio physician employed by two Florida telemedicine companies signed pre-completed orders for durable medical equipment and cancer genetic testing, falsely affirming he had examined the patients, causing more than $14.5 million in fraudulent Medicare claims.
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.