Managed care
Costa Este Medical Services LLC
Costa Este Medical Services LLC was paid $198K by Medicaid between Dec 2018 and Dec 2024, across 79 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 52% of everything it billed.
33Billing provider infoCOSTA ESTE MEDICAL SERVICES LLC
FAJARDO, PR 00738
FAJARDO, PR 00738
33aNPI1174007470assigned 09/21/2018
33bProvider typeHealth Maintenance Organization
28Total paid$198K
24GClaims252,339
24DCodes billed79
24AFirst – last monthDec 2018 – Dec 2024
Compared with peers
Next to other Health Maintenance Organization providers in Puerto Rico
Rank by total paid#9 of 37
Median peer was paid$25K
This provider vs. median7.8×
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 | 34 | $0.00 | |
| 2019 | 31,388 | $1K | |
| 2020 | 28,278 | $2K | |
| 2021 | 42,600 | $22K | |
| 2022 | 44,387 | $20K | |
| 2023 | 58,074 | $151K | |
| 2024incomplete | 47,578 | $979.99 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 52% | 128,295 | 108,280 | $103K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 28% | 30,312 | 26,309 | $55K |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 5.7% | 1,222 | 926 | $11K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.0% | 1,158 | 1,123 | $4K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.0% | 10,114 | 9,035 | $4K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.9% | 4,684 | 4,290 | $4K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.9% | 7,827 | 6,806 | $4K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 1.2% | 5,287 | 4,712 | $2K |
| 99443 | 1.1% | 609 | 548 | $2K | |
| 0134A | <1% | 38 | 20 | $2K | |
| 0124A | <1% | 34 | 18 | $1K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 1,753 | 1,421 | $1K |
67 more codes
| 0012A | <1% | 80 | $937.15 | |
| 99205 | Prolong outpt/office vis | <1% | 596 | $899.30 |
| 99442 | <1% | 1,248 | $674.60 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 1,669 | $646.74 |
| 0011A | <1% | 80 | $560.22 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 362 | $509.01 |
| 99441 | <1% | 6,200 | $264.63 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 186 | $238.00 |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 704 | $32.22 |
| 90686 | <1% | 59 | $14.37 | |
| 3074F | 0% | 6,459 | $0.00 | |
| 2010F | 0% | 3,039 | $0.00 | |
| 3008F | 0% | 5,580 | $0.00 | |
| 1170F | 0% | 2,471 | $0.00 | |
| 2001F | 0% | 686 | $0.00 | |
| 1126F | 0% | 3,165 | $0.00 | |
| 3079F | 0% | 1,151 | $0.00 | |
| 87110 | 0% | 527 | $0.00 | |
| 2000F | 0% | 2,666 | $0.00 | |
| 3075F | 0% | 559 | $0.00 | |
| 99050 | 0% | 509 | $0.00 | |
| 0509F | 0% | 378 | $0.00 | |
| 1157F | 0% | 422 | $0.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 238 | $0.00 |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 173 | $0.00 |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 167 | $0.00 |
| 3011F | 0% | 98 | $0.00 | |
| 1125F | 0% | 195 | $0.00 | |
| 1036F | 0% | 29 | $0.00 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 0% | 35 | $0.00 |
| 98962 | 0% | 257 | $0.00 | |
| 1101F | 0% | 31 | $0.00 | |
| 96127 | 0% | 142 | $0.00 | |
| 80053 | Comprehensive metabolic panel | 0% | 25 | $0.00 |
| 81000 | 0% | 36 | $0.00 | |
| 4010F | 0% | 25 | $0.00 | |
| G0008 | Administration of influenza virus vaccine | 0% | 24 | $0.00 |
| 4037F | 0% | 24 | $0.00 | |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 25 | $0.00 |
| 98968 | 0% | 188 | $0.00 | |
| 1158F | 0% | 479 | $0.00 | |
| 3725F | 0% | 1,454 | $0.00 | |
| 1160F | 0% | 4,876 | $0.00 | |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 862 | $0.00 |
| 96160 | 0% | 470 | $0.00 | |
| 0521F | 0% | 486 | $0.00 | |
| 99411 | 0% | 593 | $0.00 | |
| 3078F | 0% | 5,994 | $0.00 | |
| 1159F | 0% | 3,662 | $0.00 | |
| 4013F | 0% | 439 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 15 | $0.00 |
| 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 | 0% | 136 | $0.00 |
| 0518F | 0% | 497 | $0.00 | |
| 1090F | 0% | 31 | $0.00 | |
| 3077F | 0% | 60 | $0.00 | |
| 1033F | 0% | 36 | $0.00 | |
| 4035F | 0% | 33 | $0.00 | |
| 91312 | 0% | 34 | $0.00 | |
| 90791 | Psychiatric diagnostic evaluation | 0% | 81 | $0.00 |
| 90649 | 0% | 76 | $0.00 | |
| 90734 | 0% | 18 | $0.00 | |
| 1100F | 0% | 31 | $0.00 | |
| 90670 | 0% | 21 | $0.00 | |
| 98966 | 0% | 42 | $0.00 | |
| 80061 | Lipid panel | 0% | 21 | $0.00 |
| 90715 | 0% | 13 | $0.00 | |
| 91313 | 0% | 38 | $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 officialGONZALEZ, ISMARY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Costa Este Medical Services Corp | Fajardo, PR | $656K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.