Providers
All 16 in CA
NIRMEET RAI, M.D.
NPI 1982087789, individual, Redding, CA, Student in an Organized Health Care Education/Training Program
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 2 months, but with up to 1923 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
score 48 of 100, rank 9780, $413 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 |
|---|---|---|---|---|---|---|---|---|---|
| Dec 2020 | More hours than a day holds, even counting one unit per claim line | 33.7 | 0.2 | 0.1 | 0.2 | 1923 | 2 | 99213 | $214 |
| Aug 2021 | More hours than a day holds, even counting one unit per claim line | 29.3 | 0.2 | 0.1 | 0.2 | 1658 | 2 | 99213 | $199 |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | NIRMEET RAI, M.D. |
| Type | Individual |
| Status | Active |
| NPI issued | June 30, 2015, last updated June 30, 2015 |
| Practice location | 2480 SONOMA ST, Redding, CA 96001-3027, 530-225-7800 |
| Specialties | Student in an Organized Health Care Education/Training Program (390200000X, primary, license 39020000 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
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| T1015 | Medicaid service code | $6.2M | 99% | $167 | $182 (top 5% from $488) | 43rd percentile | |
| G0467 | Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a t | $38K | 1% | $47 | $20 (top 5% from $124) | 83rd percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $3K | 0% | $0.05 | $44 (top 5% from $110) | 2nd percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $107 | 0% | $0.06 | $28 (top 5% from $147) | 6th percentile | |
| G9920 | Medicaid service code | $29 | 0% | $0.16 | $0.17 (top 5% from $29) | too few months to rank | |
| 81003 | Automated urinalysis test | $2 | 0% | $0.00 | $1.54 (top 5% from $4.70) | 6th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $0 | 0% | $0.00 | $32 (top 5% from $49) | 2nd percentile | |
| 72100 | X-ray of lower and sacral spine, 2-3 views | $0 | 0% | $0.00 | $12 (top 5% from $55) | too few months to rank |
In this area
16 providers in Shasta County, CA carry an indicator in the public record, with $10.1M at stake between them. The most common is more hours than a day holds, on 11 of them, followed by part of a provider network on 4. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | MARK RAMUS Redding, CA, ranked 107 | $244K |
|
| 3 | NORTHERN CALIFORNIA REHABILITATION HOSPITAL, LLC Redding, CA, ranked 2241 | $0 |
|
| 3 | SOJOURN HOSPICE & PALLIATIVE CARE - REDDING, LLC. Redding, CA, ranked 3041 | $0 |
|
| 3 | LHCG XXXVIII, LLC Redding, CA, ranked 3156 | $0 |
|
| 3 | DEPARTMENT OF VETERANS AFFAIRS OF THE STATE OF CALIFORNIA Redding, CA, ranked 4220 | $0 |
|
| 4 | ORNELLA ADDONIZIO Redding, CA, ranked 7725 | $1.7M |
|
| 4 | BRIAN BAAS Anderson, CA, ranked 7755 | $1.4M |
|
| 4 | CHRISTOPHER WILLS Redding, CA, ranked 8658 | $2.4M |
|
Recent enforcement in CA
All releasesDepartment 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
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.