RAUL RODRIGUEZ-TORRES, DR
NPI 1457609505, individual, Fort Pierce, 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 | 7.9 | 79.3 | 52.9 | 78.1 | 305 | 1 | 99214 | $35K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | RAUL RODRIGUEZ-TORRES, DR |
| Type | Individual |
| Status | Active |
| NPI issued | August 21, 2012, last updated August 21, 2012 |
| Practice location | 2011 S 25TH ST STE 105, Fort Pierce, FL 34947-4795, 772-460-8235 |
| Specialties | Pediatrics (208000000X, primary, license ME54098 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 | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $748K | 53% | $61 | $60 (top 5% from $133) | 51st percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $132K | 9% | $43 | $44 (top 5% from $110) | 50th percentile | |
| 99393 | Medicaid service code | $106K | 8% | $77 | $78 (top 5% from $121) | 49th percentile | |
| 99394 | Medicaid service code | $85K | 6% | $78 | $83 (top 5% from $128) | 46th percentile | |
| 99392 | Medicaid service code | $79K | 6% | $82 | $78 (top 5% from $124) | 58th percentile | |
| 97802 | Therapy procedure for nutrition management, each 15 minutes | $61K | 4% | $27 | $3.93 (top 5% from $105) | 76th percentile | |
| 92570 | Comprehensive hearing test | $38K | 3% | $13 | $22 (top 5% from $46) | 17th percentile | |
| 99391 | Medicaid service code | $36K | 3% | $74 | $76 (top 5% from $126) | 47th percentile |
In this area
12 providers in St. Lucie County, FL carry an indicator in the public record, with $2.1M 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 | ARTURO GAMEZ Port Saint Lucie, FL, ranked 9356 | $303K |
|
| 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.