Roman, Ernesto

Roman, Ernesto was paid $5K by Medicaid between Jan 2018 and Oct 2024, across 9 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 66% of everything it billed.

33Billing provider infoROMAN, ERNESTO
VEGA BAJA, PR 00693

33aNPI1104928423assigned 09/05/2006

33bProvider typeGeneral Practice Physician

28Total paid$5K

24GClaims12,807

24DCodes billed9

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other General Practice Physician providers in Puerto Rico

Rank by total paid#491 of 1,195

Median peer was paid$2K

This provider vs. median2.4×

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	1,455	$0.00
2019	1,770	$0.00
2020	1,524	$2K
2021	1,772	$3K
2022	1,584	$360.00
2023	1,777	$0.00
2024incomplete	2,925	$0.00

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	66%	214	206	$3K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	15%	14	13	$744.00
99441		10%	1,441	1,344	$524.00
99222	Initial hospital care, per day, moderate complexity	3.9%	13	12	$196.84
99238	Hospital discharge day management, 30 minutes or less	2.1%	14	13	$104.30
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	2.0%	7,061	5,714	$98.57
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion	1.1%	28	24	$56.74
99442		0%	254	236	$0.00
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	0%	3,768	2,196	$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.