Managed care
Asociacion De Medicos Del Oeste, INC.
Asociacion De Medicos Del Oeste, INC. was paid $34K by Medicaid between Feb 2019 and Dec 2024, across 33 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 87% of everything it billed.
33Billing provider infoASOCIACION DE MEDICOS DEL OESTE, INC.
ANASCO, PR 00610
ANASCO, PR 00610
33aNPI1174737571assigned 05/09/2007
33bProvider typeHealth Maintenance Organization
28Total paid$34K
24GClaims49,205
24DCodes billed33
24AFirst – last monthFeb 2019 – Dec 2024
Compared with peers
Next to other Health Maintenance Organization providers in Puerto Rico
Rank by total paid#17 of 37
Median peer was paid$25K
This provider vs. median1.3×
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 | 5,631 | $2K | |
| 2020 | 8,617 | $5K | |
| 2021 | 10,916 | $19K | |
| 2022 | 12,115 | $3K | |
| 2023 | 8,232 | $4K | |
| 2024incomplete | 3,694 | $560.00 |
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 | 87% | 11,725 | 5,812 | $29K |
| 96160 | 6.9% | 389 | 254 | $2K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 3.4% | 6,027 | 2,724 | $1K |
| 99442 | 2.8% | 44 | 20 | $945.33 | |
| 1125F | <1% | 1,204 | 542 | $0.02 | |
| 3074F | <1% | 6,341 | 3,000 | $0.02 | |
| 1170F | <1% | 3,548 | 1,502 | $0.01 | |
| 3078F | <1% | 5,065 | 2,412 | $0.01 | |
| 1126F | 0% | 3,222 | 1,476 | $0.00 | |
| 4010F | 0% | 796 | 383 | $0.00 | |
| 96156 | 0% | 248 | 118 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 419 | 244 | $0.00 |
21 more codes
| 3008F | 0% | 1,440 | $0.00 | |
| 96127 | 0% | 329 | $0.00 | |
| 3079F | 0% | 159 | $0.00 | |
| 1157F | 0% | 835 | $0.00 | |
| 99441 | 0% | 94 | $0.00 | |
| 99205 | Prolong outpt/office vis | 0% | 42 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 84 | $0.00 |
| 99401 | 0% | 418 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 43 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 4,710 | $0.00 |
| 99173 | 0% | 17 | $0.00 | |
| 0521F | 0% | 936 | $0.00 | |
| 1159F | 0% | 103 | $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% | 393 | $0.00 |
| 3088F | 0% | 214 | $0.00 | |
| 1158F | 0% | 78 | $0.00 | |
| 3725F | 0% | 78 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 49 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 93 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 20 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 42 | $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 officialSANCHEZ, MERVIN (ADMINISTRATOR)