Encarnacion, Roberto

Encarnacion, Roberto was paid $9K by Medicaid between Jan 2018 and Dec 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 — 65% of everything it billed.

33Billing provider infoENCARNACION, ROBERTO
BARRANQUITAS, PR 00794

33aNPI1154480473assigned 12/06/2006

33bProvider typeGeneral Practice Physician

28Total paid$9K

24GClaims12,332

24DCodes billed9

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other General Practice Physician providers in Puerto Rico

Rank by total paid#420 of 1,195

Median peer was paid$2K

This provider vs. median4.4×

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	2,293	$566.32
2019	1,906	$436.50
2020	1,141	$1K
2021	1,699	$2K
2022	1,590	$1K
2023	1,874	$4K
2024incomplete	1,829	$181.64

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	65%	3,316	2,926	$6K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	34%	8,367	6,845	$3K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	1.5%	99	97	$129.80
3074F		0%	16	16	$0.00
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	0%	466	403	$0.00
1159F		0%	16	16	$0.00
96160		0%	19	17	$0.00
3078F		0%	17	17	$0.00
1160F		0%	16	16	$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.