Managed care
Corporacion Medica Oriental
Corporacion Medica Oriental was paid $239K by Medicaid between May 2018 and Oct 2024, across 14 billing codes. Its largest line is S9097, Home visit for wound care — 92% of everything it billed.
33Billing provider infoCORPORACION MEDICA ORIENTAL
HUMACAO, PR 00791
HUMACAO, PR 00791
33aNPI1073706644assigned 08/27/2007
33bProvider typeHealth Maintenance Organization
28Total paid$239K
24GClaims5,723
24DCodes billed14
24AFirst – last monthMay 2018 – Oct 2024
Compared with peers
Next to other Health Maintenance Organization providers in Puerto Rico
Rank by total paid#8 of 37
Median peer was paid$25K
This provider vs. median9.5×
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 | 710 | $3K | |
| 2019 | 543 | $3K | |
| 2020 | 1,717 | $91K | |
| 2021 | 2,163 | $122K | |
| 2022 | 310 | $14K | |
| 2023 | 126 | $1K | |
| 2024incomplete | 154 | $6K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| S9097 | Home visit for wound care | 92% | 3,360 | 584 | $220K |
| T1030 | Nursing care, in the home, by registered nurse, per diem | 3.8% | 121 | 115 | $9K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.3% | 1,340 | 1,196 | $8K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.0% | 443 | 400 | $2K |
| 90688 | <1% | 20 | 13 | $192.98 | |
| 90656 | <1% | 46 | 45 | $73.88 | |
| 90686 | <1% | 167 | 157 | $44.04 | |
| 90633 | 0% | 47 | 45 | $0.00 | |
| 90648 | 0% | 15 | 15 | $0.00 | |
| 90670 | 0% | 32 | 32 | $0.00 | |
| 90715 | 0% | 21 | 21 | $0.00 | |
| 90734 | 0% | 38 | 37 | $0.00 |
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.
From NPPES
Who's on the registration
Authorized officialPRATTS DIAZ, MAYLENE (ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Arse INC. | Humacao, PR | $36K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.