Cespedes Santana, Monica

Cespedes Santana, Monica was paid $162K by Medicaid between Dec 2019 and Apr 2022, across 15 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 26% of everything it billed.

33Billing provider infoCESPEDES SANTANA, MONICA
SAN JUAN, PR 00907

33aNPI1114204161assigned 11/04/2011

33bProvider typeInfectious Disease Physician

28Total paid$162K

24GClaims5,261

24DCodes billed15

24AFirst – last monthDec 2019 – Apr 2022

Compared with peers

Next to other Infectious Disease Physician providers in Puerto Rico

Rank by total paid#25 of 57

Median peer was paid$106K

This provider vs. median1.5×

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
2019	25	$478.00
2020	1,682	$54K
2021	2,614	$81K
2022	940	$26K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	26%	643	533	$43K
99254		19%	374	345	$31K
99443		16%	361	322	$25K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	11%	364	329	$18K
99253		6.3%	178	158	$10K
99308	Subsequent nursing facility care, per day, straightforward	4.3%	800	536	$7K
99309	Subsequent nursing facility care, per day, low to moderate complexity	3.1%	758	614	$5K
99305		3.0%	513	510	$5K
99310	Prolong nursin fac eval 15m	2.9%	624	504	$5K
99306	Prolong nursin fac eval 15m	2.3%	195	189	$4K
99442		2.3%	70	66	$4K
99252		1.9%	67	57	$3K

3 more codes

99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	30	$1K
99307		<1%	200	$1K
99304		<1%	84	$732.46

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.