CAROL LEE SPAGNOLO-HYE, D.O.
NPI 1588822456, individual, Spring Hill, FL, Pediatrics
- Hours beyond a day in 5 months, but with up to 1143 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- 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 |
|---|---|---|---|---|---|---|---|---|---|
| Jan 2022 | More hours than a day holds at a conservative unit price | 12.0 | 46.8 | 31.2 | 46.1 | 833 | 1 | 97802 99213 99214 99401 99441 99442 G0447 | $106K |
| Aug 2022 | More hours than a day holds at a conservative unit price | 13.9 | 37.4 | 24.9 | 33.6 | 1143 | 1 | 97802 99213 99214 99401 99441 99442 G0444 G0447 | $82K |
| Oct 2022 | More hours than a day holds at a conservative unit price | 13.2 | 36.6 | 24.4 | 36.0 | 1088 | 1 | 97802 99213 99214 99401 99441 99442 G0444 G0447 | $78K |
| Nov 2022 | More hours than a day holds at a conservative unit price | 14.8 | 39.9 | 26.6 | 36.2 | 1001 | 1 | 97802 99204 99213 99214 99401 99441 99442 G0447 | $89K |
| Feb 2023 | More hours than a day holds at a conservative unit price | 17.7 | 43.1 | 28.7 | 40.2 | 1136 | 1 | 97802 99204 99213 99214 99441 99442 G0447 | $95K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | CAROL LEE SPAGNOLO-HYE, D.O. |
| Type | Individual |
| Status | Active |
| NPI issued | May 28, 2008, last updated March 27, 2024 |
| Practice location | 8391 OMAHA CIR, Spring Hill, FL 34606-5157, 352-688-8818 |
| Specialties | Pediatrics (208000000X, primary, license OS 10377 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 | $1.3M | 37% | $106 | $60 (top 5% from $133) | 88th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $781K | 22% | $74 | $44 (top 5% from $110) | 85th percentile | |
| 99393 | Medicaid service code | $207K | 6% | $89 | $78 (top 5% from $121) | 69th percentile | |
| 99394 | Medicaid service code | $169K | 5% | $94 | $83 (top 5% from $128) | 67th percentile | |
| 87637 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus | $163K | 5% | $86 | $114 (top 5% from $186) | 31st percentile | |
| 99392 | Medicaid service code | $123K | 3% | $89 | $78 (top 5% from $124) | 66th percentile | |
| 97802 | Therapy procedure for nutrition management, each 15 minutes | $99K | 3% | $18 | $3.93 (top 5% from $105) | 69th percentile | |
| 90460 | Administration of first vaccine or toxoid component with counseling (18 years or younger) | $94K | 3% | $22 | $26 (top 5% from $54) | 39th percentile |
In this area
5 providers in Hernando County, FL carry an indicator in the public record, with $1.9M at stake between them. The most common is more hours than a day holds, on 3 of them, followed by part of a provider network on 2.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | HERNANDO-PASCO HOSPICE, INC. Brooksville, FL, ranked 4813 | $0 |
|
| 3 | PINNACLE HOME CARE OF SPRING HILL, LLC. Spring Hill, FL, ranked 6302 | $0 |
|
| 5 | MICHAEL GRIFFEN Spring Hill, FL, ranked 9999 | $1.8M |
|
| 5 | MICHELE BOWMAN Spring Hill, FL, ranked 10444 | $124K |
|
| 5 | JONADAB UZOHO Spring Hill, FL, ranked 11759 | $47K |
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.