Hernandez Montalvo, Edgar

Hernandez Montalvo, Edgar was paid $434K by Medicaid between Oct 2018 and Oct 2024, across 8 billing codes. Its largest line is 90960, End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits — 41% of everything it billed.

33Billing provider infoHERNANDEZ MONTALVO, EDGAR
MANATI, PR 00674

33aNPI1033469390assigned 09/14/2012

33bProvider typeNephrology Physician

28Total paid$434K

24GClaims5,264

24DCodes billed8

24AFirst – last monthOct 2018 – Oct 2024

Compared with peers

Next to other Nephrology Physician providers in Puerto Rico

Rank by total paid#9 of 81

Median peer was paid$66K

This provider vs. median6.6×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2018	32	$480.00
2019	601	$18K
2020	1,048	$72K
2021	929	$79K
2022	486	$47K
2023	796	$87K
2024incomplete	1,372	$130K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
90960	End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits	41%	895	781	$180K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	27%	2,460	901	$117K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	19%	1,321	1,190	$82K
90961		5.1%	103	90	$22K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	3.6%	215	199	$15K
90935	Hemodialysis procedure with single evaluation by a physician	1.9%	128	52	$8K
99222	Initial hospital care, per day, moderate complexity	1.6%	65	47	$7K
99253		<1%	77	76	$3K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.