Providers
All 14 in FL
SCOTT WILLIAM VANLUE, MD
NPI 1174649412, individual, Altamonte Springs, FL, Family Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 18 months, but with up to 1939 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
- Medicaid dollars per patient on code 99203 ($155 per patient-month) sit in the top 5% of every provider billing that code.
score 56 of 100, rank 7406, $7.1M 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 |
|---|---|---|---|---|---|---|---|---|---|
| Feb 2021 | More hours than a day holds at a conservative unit price | 15.9 | 42.4 | 28.3 | 39.6 | 1167 | 1 | 99202 99203 99204 99212 99213 99214 | $182K |
| Mar 2021 | More hours than a day holds at a conservative unit price | 14.0 | 38.7 | 25.8 | 34.8 | 1102 | 1 | 99202 99203 99204 99212 99213 99214 | $179K |
| Apr 2021 | More hours than a day holds at a conservative unit price | 14.4 | 41.7 | 27.8 | 37.9 | 1192 | 1 | 99202 99203 99204 99212 99213 99214 | $192K |
| May 2021 | More hours than a day holds at a conservative unit price | 14.0 | 40.4 | 26.9 | 39.8 | 1159 | 3 | 99202 99203 99204 99212 99213 99214 | $188K |
| Aug 2021 | More hours than a day holds at a conservative unit price | 16.1 | 41.9 | 27.9 | 39.4 | 1449 | 1 | 99202 99203 99212 99213 99214 | $231K |
| Sep 2021 | More hours than a day holds at a conservative unit price | 23.5 | 58.9 | 39.3 | 53.6 | 1939 | 1 | 99202 99203 99204 99211 99212 99213 99214 | $304K |
| Oct 2021 | More hours than a day holds at a conservative unit price | 18.8 | 45.6 | 30.4 | 44.8 | 1540 | 1 | 99202 99203 99204 99212 99213 99214 | $237K |
| Nov 2021 | More hours than a day holds at a conservative unit price | 19.9 | 46.4 | 31.0 | 42.2 | 1527 | 1 | 99202 99203 99212 99213 99214 | $231K |
| Feb 2022 | More hours than a day holds at a conservative unit price | 14.5 | 36.9 | 24.6 | 34.4 | 1072 | 1 | 99202 99203 99212 99213 99214 99215 | $172K |
| Jan 2023 | More hours than a day holds at a conservative unit price | 17.8 | 36.9 | 24.6 | 34.6 | 1081 | 1 | 99203 99204 99213 99214 | $168K |
| Feb 2023 | More hours than a day holds at a conservative unit price | 22.3 | 47.3 | 31.6 | 44.2 | 1232 | 1 | 99203 99204 99213 99214 | $191K |
| Mar 2023 | More hours than a day holds at a conservative unit price | 21.9 | 45.4 | 30.3 | 40.8 | 1327 | 1 | 99203 99204 99213 99214 | $202K |
| Apr 2023 | More hours than a day holds at a conservative unit price | 21.9 | 44.5 | 29.7 | 44.5 | 1300 | 1 | 99203 99204 99213 99214 | $192K |
| May 2023 | More hours than a day holds, even counting one unit per claim line | 24.1 | 47.5 | 31.7 | 42.7 | 1400 | 1 | 99203 99204 99213 99214 | $214K |
| Aug 2023 | More hours than a day holds at a conservative unit price | 20.7 | 37.6 | 25.1 | 33.8 | 1068 | 1 | 99203 99204 99213 99214 | $166K |
| Sep 2023 | More hours than a day holds at a conservative unit price | 20.9 | 41.3 | 27.5 | 39.3 | 1149 | 1 | 99203 99204 99213 99214 | $178K |
| Oct 2023 | More hours than a day holds at a conservative unit price | 20.7 | 42.2 | 28.1 | 39.6 | 1177 | 1 | 99203 99204 99213 99214 | $185K |
| Nov 2023 | More hours than a day holds at a conservative unit price | 21.1 | 41.6 | 27.7 | 37.8 | 1168 | 1 | 99203 99204 99213 99214 | $175K |
| Dec 2023 | More hours than a day holds at a conservative unit price | 18.0 | 36.6 | 24.4 | 36.0 | 1041 | 1 | 99203 99204 99213 99214 | $159K |
| Feb 2024 | More hours than a day holds at a conservative unit price | 23.3 | 41.4 | 27.6 | 38.1 | 1021 | 1 | 99203 99204 99213 99214 | $169K |
| Apr 2024 | More hours than a day holds, even counting one unit per claim line | 29.6 | 34.6 | 23.1 | 31.4 | 991 | 1 | 99203 99204 99213 99214 | $150K |
| Nov 2024 | More hours than a day holds at a conservative unit price | 18.7 | 38.1 | 25.4 | 36.3 | 1098 | 1 | 99203 99204 99213 99214 | $164K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | SCOTT WILLIAM VANLUE, MD |
| Type | Individual |
| Status | Active |
| NPI issued | March 21, 2007, last updated April 15, 2016 |
| Practice location | 940 CENTRE CIR, SUITE 1010, Altamonte Springs, FL 32714-7604, 407-862-5637 |
| Mailing address | 1208 DUNLAWTON AVE, Port Orange, FL 32127-4746 |
| Specialties | Family Medicine (207Q00000X, primary, license ME51026 FL) |
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 | $3.3M | 37% | $144 | $44 (top 5% from $110) | 97th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $2.2M | 25% | $155 | $60 (top 5% from $133) | 97th percentile | |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | $1.7M | 19% | $144 | $67 (top 5% from $121) | 98th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $784K | 9% | $152 | $95 (top 5% from $171) | 90th percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $335K | 4% | $141 | $28 (top 5% from $147) | 95th percentile | |
| 99202 | New patient office or other outpatient visit with straightforward medical decision making, if using time, 15 minutes or more | $332K | 4% | $147 | $45 (top 5% from $138) | 96th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $87K | 1% | $6.55 | $32 (top 5% from $49) | 11th percentile | |
| S9083 | Medicaid service code | $22K | 0% | $152 | $113 (top 5% from $163) | 86th 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 | 420 | 379 | $36K | $322 | $123 | 2.6x | 2.3x (90th percentile 3.8x) |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | 304 | 304 | $31K | $498 | $162 | 3.1x | 2.4x (90th percentile 3.9x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 104 | 101 | $7K | $219 | $87 | 2.5x | 2.2x (90th percentile 3.8x) |
| 99203 | New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more | 80 | 80 | $6K | $326 | $108 | 3.0x | 2.4x (90th percentile 3.9x) |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | 175 | 169 | $6K | $65 | $34 | 1.9x | 2.8x (90th percentile 4.4x) |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | 151 | 147 | $2K | $49 | $16 | 3.0x | 2.5x (90th percentile 3.9x) |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | 40 | 39 | $648 | $49 | $16 | 3.0x | 2.6x (90th percentile 4.1x) |
| 71046 | X-ray of chest, 2 views | 26 | 26 | $549 | $79 | $27 | 2.9x | 3.6x (90th percentile 8.1x) |
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
14 providers in Seminole County, FL carry an indicator in the public record, with $34.4M 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 3.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | ADVENTHEALTH HOME HEALTH AND HOSPICE INC Altamonte Springs, FL, ranked 1942 | $0 |
|
| 3 | ADVENTHEALTH HOME HEALTH AND HOSPICE INC Altamonte Springs, FL, ranked 2271 | $0 |
|
| 3 | HOME HEALTH AREA 7, LLC Altamonte Springs, FL, ranked 6577 | $0 |
|
| 4 | VENESSA THOMAS Altamonte Springs, FL, ranked 7318 | $1.3M |
|
| 4 | TIMOTHY HENDRIX Sanford, FL, ranked 7346 | $25.6M |
|
| 4 | PAMELA ROWE Longwood, FL, ranked 7571 | $2.9M |
|
| 5 | GERMANO FALCAO Oviedo, FL, ranked 10080 | $1.2M |
|
| 5 | FRANCO VALLEJO GARCIA Lake Mary, FL, ranked 10132 | $897K |
|
Recent enforcement in FL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJPleaded guiltyAug 14, 2026
Ocala Mental Health Counselor Pleads Guilty to Aggravated Identity Theft and Wire Fraud
Forsythe used the names and insurance policy information of 22 individuals without their consent to bill two health insurance companies for counseling services she had not provided.
DOJConvictedAug 12, 2026
Cuban National Convicted of Unlawfully Obtaining US Citizenship After Concealing Healthcare Fraud Scheme
Rodriguez concealed on her naturalization application her participation in a seven-year healthcare fraud conspiracy that resulted in approximately $4.6 million in fraudulent healthcare claims.
DOJCivil settlementAug 3, 2026
Medicare Advantage Provider Complete Health to Pay $14,100,000 to Settle False Claims Act Suit
Complete Health caused the submission of diagnosis codes within HCC 55 and HCC 59 that were not clinically valid, not supported by medical records, and/or not considered in the beneficiary's care, increasing Medicare Advantage risk-adjusted payments from which it received a percentage.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses, with one practice receiving remuneration from a third-party testing company to refer patients for the tests.
DOJCivil settlementJul 31, 2026
Two Additional Ophthalmology Practices Agree to Pay $2.3M to Resolve Allegations of Fraudulent Claims to Medicare and Medicaid for Cranial Ultrasounds
Two ophthalmology practices billed Medicare and Medicaid for medically unnecessary trans-cranial doppler ultrasounds premised on false diagnoses and, as to Floral Park Ophthalmology, resulting from remuneration paid by a third-party testing company to induce referrals.
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.