ARTURO GAMEZ, M.D
NPI 1386830479, individual, Port Saint Lucie, FL, Pediatrics
- Hours beyond a day in 1 month under one organization, which can be supervisory billing.
- Records needed.
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 2018 | More hours than a day holds at a conservative unit price | 3.6 | 44.8 | 29.9 | 44.1 | 231 | 1 | 99213 99214 | $26K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | ARTURO GAMEZ, M.D |
| Type | Individual |
| Status | Active |
| NPI issued | September 21, 2007, last updated February 5, 2020 |
| Practice location | 2115 SE LENNARD RD, Port Saint Lucie, FL 34952-4742, 772-335-1812 |
| Specialties | Pediatrics (208000000X, primary, license ME 104786 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.
| 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 | $712K | 34% | $67 | $44 (top 5% from $110) | 79th percentile | |
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $550K | 27% | $86 | $60 (top 5% from $133) | 75th percentile | |
| 99393 | Medicaid service code | $161K | 8% | $76 | $78 (top 5% from $121) | 47th percentile | |
| 99392 | Medicaid service code | $157K | 8% | $87 | $78 (top 5% from $124) | 65th percentile | |
| 99394 | Medicaid service code | $135K | 6% | $83 | $83 (top 5% from $128) | 50th percentile | |
| 90460 | Administration of first vaccine or toxoid component with counseling (18 years or younger) | $109K | 5% | $21 | $26 (top 5% from $54) | 38th percentile | |
| 99391 | Medicaid service code | $75K | 4% | $99 | $76 (top 5% from $126) | 83rd percentile | |
| 99212 | Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more | $52K | 3% | $86 | $28 (top 5% from $147) | 90th percentile |
In this area
12 providers in St. Lucie County, FL carry an indicator in the public record, with $2.2M at stake between them. The most common is more hours than a day holds, on 8 of them, followed by part of a provider network on 4.
| tier | provider | at stake | why |
|---|---|---|---|
| 2 | HUMAYUN SHAREEF FT Pierce, FL, ranked 738 | $406K |
|
| 3 | PINNACLE HOME CARE OF THE PALM BEACHES, LLC. Port ST Lucie, FL, ranked 1975 | $0 |
|
| 3 | HOSPICE OF THE TREASURE COAST INC Fort Pierce, FL, ranked 2187 | $0 |
|
| 3 | LIGHTHOUSE HOME HEALTH AGENCY, LLC Port ST Lucie, FL, ranked 3350 | $0 |
|
| 3 | ACCESS HOME HEALTH OF FLORIDA, LLC Port Saint Lucie, FL, ranked 7189 | $0 |
|
| 4 | KELLY HARRIS Port Saint Lucie, FL, ranked 7880 | $775K |
|
| 4 | RAUL RODRIGUEZ-TORRES Fort Pierce, FL, ranked 9274 | $408K |
|
| 4 | ERNESTO BARRAL Port Saint Lucie, FL, ranked 9707 | $20K |
|
Recent enforcement in FL
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
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.