Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

COSTA ESTE MEDICAL SERVICES LLC

NPI: 1174007470 · FAJARDO, PR 00738 · Health Maintenance Organization · NPI assigned 09/21/2018

$198K
Total Medicaid Paid
252,339
Total Claims
219,019
Beneficiaries
79
Codes Billed
2018-12
First Month
2024-12
Last Month

Provider Details

Authorized OfficialGONZALEZ, ISMARY (PRESIDENT)
NPI Enumeration Date09/21/2018

Related Entities

Other providers sharing the same authorized official: GONZALEZ, ISMARY

ProviderCityStateTotal Paid
COSTA ESTE MEDICAL SERVICES CORP FAJARDO PR $656K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal 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
2024 47,578 $979.99

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 128,295 108,280 $103K
99215 Prolong outpt/office vis 30,312 26,309 $55K
Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory 1,222 926 $11K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 1,158 1,123 $4K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 10,114 9,035 $4K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4,684 4,290 $4K
99392 Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) 7,827 6,806 $4K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 5,287 4,712 $2K
99443 609 548 $2K
0134A 38 20 $2K
0124A 34 18 $1K
99391 Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) 1,753 1,421 $1K
0012A 80 23 $937.15
99205 Prolong outpt/office vis 596 568 $899.30
99442 1,248 1,102 $674.60
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 1,669 1,529 $646.74
0011A 80 23 $560.22
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 362 220 $509.01
99441 6,200 5,714 $264.63
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years 186 162 $238.00
G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination 704 538 $32.22
90686 59 58 $14.37
3074F 6,459 6,011 $0.00
2010F 3,039 2,853 $0.00
3008F 5,580 5,118 $0.00
1170F 2,471 2,223 $0.00
2001F 686 595 $0.00
1126F 3,165 2,952 $0.00
3079F 1,151 1,091 $0.00
87110 527 397 $0.00
2000F 2,666 2,548 $0.00
3075F 559 535 $0.00
99050 509 481 $0.00
0509F 378 309 $0.00
1157F 422 350 $0.00
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 238 186 $0.00
90834 Psychotherapy, 45 minutes with patient 173 157 $0.00
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 167 151 $0.00
3011F 98 98 $0.00
1125F 195 182 $0.00
1036F 29 27 $0.00
85025 Blood count; complete (CBC), automated, and automated differential WBC count 35 35 $0.00
98962 257 234 $0.00
1101F 31 29 $0.00
96127 142 140 $0.00
80053 Comprehensive metabolic panel 25 25 $0.00
81000 36 35 $0.00
4010F 25 25 $0.00
G0008 Administration of influenza virus vaccine 24 24 $0.00
4037F 24 24 $0.00
84443 Thyroid stimulating hormone (TSH) 25 25 $0.00
98968 188 167 $0.00
1158F 479 391 $0.00
3725F 1,454 1,262 $0.00
1160F 4,876 4,448 $0.00
90832 Psychotherapy, 30 minutes with patient 862 800 $0.00
96160 470 418 $0.00
0521F 486 400 $0.00
99411 593 580 $0.00
3078F 5,994 5,598 $0.00
1159F 3,662 3,281 $0.00
4013F 439 386 $0.00
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years 15 13 $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 136 126 $0.00
0518F 497 416 $0.00
1090F 31 29 $0.00
3077F 60 59 $0.00
1033F 36 33 $0.00
4035F 33 29 $0.00
91312 34 18 $0.00
90791 Psychiatric diagnostic evaluation 81 81 $0.00
90649 76 56 $0.00
90734 18 18 $0.00
1100F 31 29 $0.00
90670 21 12 $0.00
98966 42 30 $0.00
80061 Lipid panel 21 21 $0.00
90715 13 13 $0.00
91313 38 20 $0.00