Providers
All 52 in FL
LUIS F YCAZA, D.O.
NPI 1366480311, individual, St Petersburg, FL, Internal Medicine
4
Evidence tier
structure or single-organization volume
- Hours beyond a day in 14 months, but with up to 531 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 9157, $579K 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 |
|---|---|---|---|---|---|---|---|---|---|
| Aug 2021 | More hours than a day holds at a conservative unit price | 18.6 | 36.4 | 24.3 | 34.2 | 511 | 1 | 99306 99307 99308 99309 99310 99336 | $16K |
| Sep 2021 | More hours than a day holds at a conservative unit price | 15.9 | 37.1 | 24.7 | 33.7 | 457 | 1 | 99306 99308 99309 99310 99336 | $17K |
| Oct 2021 | More hours than a day holds at a conservative unit price | 16.6 | 45.1 | 30.0 | 44.4 | 493 | 1 | 99306 99307 99308 99309 99310 99336 | $21K |
| Nov 2021 | More hours than a day holds at a conservative unit price | 15.3 | 50.1 | 33.4 | 45.5 | 446 | 1 | 99306 99307 99308 99309 99310 99336 | $22K |
| Dec 2021 | More hours than a day holds at a conservative unit price | 11.8 | 38.5 | 25.7 | 34.6 | 452 | 1 | 99306 99307 99308 99309 99310 99336 | $18K |
| Jan 2022 | More hours than a day holds at a conservative unit price | 13.3 | 80.8 | 53.9 | 79.5 | 357 | 1 | 99306 99308 99309 99336 | $29K |
| Feb 2022 | More hours than a day holds at a conservative unit price | 12.5 | 72.6 | 48.4 | 67.8 | 403 | 1 | 99306 99308 99309 99336 | $23K |
| Apr 2022 | More hours than a day holds at a conservative unit price | 10.1 | 48.4 | 32.2 | 46.0 | 350 | 1 | 99306 99307 99308 99309 99336 | $16K |
| May 2022 | More hours than a day holds at a conservative unit price | 14.4 | 48.3 | 32.2 | 45.3 | 394 | 1 | 99306 99308 99309 99310 99336 | $17K |
| Jun 2022 | More hours than a day holds at a conservative unit price | 11.9 | 44.7 | 29.8 | 40.6 | 331 | 1 | 99306 99308 99309 99336 | $15K |
| Jul 2022 | More hours than a day holds at a conservative unit price | 12.6 | 50.1 | 33.4 | 49.3 | 375 | 1 | 99306 99308 99309 99336 | $18K |
| Aug 2022 | More hours than a day holds at a conservative unit price | 12.6 | 47.9 | 31.9 | 43.0 | 307 | 1 | 99308 99309 99336 | $16K |
| Sep 2022 | More hours than a day holds at a conservative unit price | 10.1 | 47.8 | 31.9 | 43.5 | 361 | 1 | 99306 99308 99309 99336 | $18K |
| Oct 2022 | More hours than a day holds at a conservative unit price | 7.3 | 42.4 | 28.3 | 41.8 | 404 | 1 | 99306 99307 99308 99309 99336 | $18K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | LUIS F YCAZA, D.O. |
| Type | Individual |
| Status | Active |
| NPI issued | June 3, 2006, last updated January 14, 2020 |
| Practice location | 1839 CENTRAL AVE, St Petersburg, FL 33713-8900, 727-322-1054 |
| Specialties | Internal Medicine (207R00000X, primary, license OS7473 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 | |
|---|---|---|---|---|---|---|---|
| Q5003 | Medicaid service code | $404K | 38% | $4K | $94 (top 5% from $6K) | 69th percentile | |
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | $258K | 24% | $34 | $21 (top 5% from $84) | 74th percentile | |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | $173K | 16% | $25 | $14 (top 5% from $58) | 77th percentile | |
| 99336 | Domiciliary/rest home visit established level 3 (retired 2023) | $57K | 5% | $29 | $28 (top 5% from $90) | 52nd percentile | |
| 99307 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes | $51K | 5% | $16 | $7.86 (top 5% from $34) | 81st percentile | |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | $46K | 4% | $66 | $37 (top 5% from $100) | 80th percentile | |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | $44K | 4% | $74 | $30 (top 5% from $134) | 85th percentile | |
| 99335 | Domiciliary/rest home visit established level 2 (retired 2023) | $14K | 1% | $17 | $19 (top 5% from $69) | 46th 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 |
|---|---|---|---|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 2,391 | 532 | $198K | $184 | $105 | 1.8x | 2.0x (90th percentile 3.3x) |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more | 1,198 | 437 | $67K | $144 | $72 | 2.0x | 2.0x (90th percentile 3.4x) |
| 99349 | Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes | 322 | 79 | $31K | $256 | $124 | 2.1x | 2.0x (90th percentile 3.4x) |
| 99306 | Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more | 130 | 124 | $18K | $336 | $177 | 1.9x | 1.9x (90th percentile 3.1x) |
| 99496 | Transitional care management services for problem of high complexity | 46 | 33 | $10K | $555 | $270 | 2.1x | 1.9x (90th percentile 3.1x) |
| 99348 | Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes | 118 | 72 | $6K | $166 | $74 | 2.3x | 2.1x (90th percentile 3.6x) |
| 99305 | Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes | 40 | 40 | $4K | $259 | $130 | 2.0x | 2.0x (90th percentile 3.3x) |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and | 77 | 70 | $3K | $109 | $52 | 2.1x | 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
52 providers in Pinellas County, FL carry an indicator in the public record, with $24.3M at stake between them. The most common is more hours than a day holds, on 32 of them, followed by part of a provider network on 20.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | THE HOSPICE OF THE FLORIDA SUNCOAST, INC. Palm Harbor, FL, ranked 1071 | $833K |
|
| 3 | PROHEALTH HOME HEALTH SERVICES, INC ST Petersburg, FL, ranked 2625 | $0 |
|
| 3 | CENTERWELL HEALTH SERVICES (CERTIFIED), INC. Clearwater, FL, ranked 2848 | $0 |
|
| 3 | HARBOURWOOD FL OPCO LLC Clearwater, FL, ranked 3475 | $0 |
|
| 3 | ALBORADA HOME HEALTH OF TAMPA, INC ST Petersburg, FL, ranked 3779 | $0 |
|
| 3 | WESTCHESTER GARDENS LIMITED PARTNERSHIP Clearwater, FL, ranked 4549 | $0 |
|
| 3 | EMPATH HOME HEALTH LLC Palm Harbor, FL, ranked 4619 | $0 |
|
| 3 | DANNY'S HOME HEALTH CARE OF FLORIDA INC. Largo, FL, ranked 4753 | $0 |
|
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.