Providers

RAISA D CAMILO, M.D

NPI 1427048495, individual, Sebring, FL, Pediatrics

5
Evidence tier
informational
score 31 of 100, rank 10739, $3.0M at stake

National provider registry

From the CMS NPPES Registry, refreshed daily.

NameRAISA D CAMILO, M.D
TypeIndividual
StatusActive
NPI issuedOctober 21, 2005, last updated November 9, 2009
Practice location4958 SUN N LAKE BLVD, Sebring, FL 33872-2167, 863-385-4711
Specialties
Pediatrics (208000000X, primary, license ME0061030 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
codewhat it ispaidshareper patient-monthtypicalrank among providers
99213Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more$1.7M32%$48$44 (top 5% from $110)56th percentile
99214Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more$930K17%$57$60 (top 5% from $133)46th percentile
99392Medicaid service code$447K8%$80$78 (top 5% from $124)55th percentile
99391Medicaid service code$420K8%$86$76 (top 5% from $126)64th percentile
99393Medicaid service code$375K7%$80$78 (top 5% from $121)55th percentile
99394Medicaid service code$283K5%$80$83 (top 5% from $128)47th percentile
97802Therapy procedure for nutrition management, each 15 minutes$261K5%$19$3.93 (top 5% from $105)70th percentile
99212Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more$174K3%$36$28 (top 5% from $147)65th percentile

In this area

2 providers in Highlands County, FL carry an indicator in the public record, with $202K at stake between them. The most common is part of a provider network, on 1 of them, followed by more hours than a day holds on 1.

tierproviderat stakewhy
3ADVENTHEALTH HOME HEALTH AND HOSPICE, INC.
Sebring, FL, ranked 3925
$0
  • Part of provider network D1-00071, ranked 71 nationally.
4NICHOLAS LUKERT
Lake Placid, FL, ranked 9468
$202K
  • Hours beyond a day in 1 month, but with up to 671 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
  • Records needed.

Recent enforcement in FL

All releases

Department 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.

Ask this case

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