Physician
Ortiz Diaz, Efrain
Ortiz Diaz, Efrain was paid $161.61 by Medicaid between Jan 2018 and Oct 2024, across 11 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 100% of everything it billed.
33Billing provider infoORTIZ DIAZ, EFRAIN
TOA BAJA, PR 00949
TOA BAJA, PR 00949
33aNPI1194751040assigned 06/23/2006
33bProvider typeGeneral Practice Physician
28Total paid$161.61
24GClaims2,267
24DCodes billed11
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other General Practice Physician providers in Puerto Rico
Rank by total paid#822 of 1,195
Median peer was paid$2K
This provider vs. median0.1×
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 | 229 | $0.00 | |
| 2019 | 15 | $0.00 | |
| 2020 | 145 | $0.00 | |
| 2021 | 310 | $0.00 | |
| 2022 | 564 | $0.00 | |
| 2023 | 592 | $69.26 | |
| 2024incomplete | 412 | $92.35 |
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 | 100% | 1,380 | 1,291 | $161.61 |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 0% | 136 | 135 | $0.00 |
| 1158F | 0% | 386 | 378 | $0.00 | |
| 99442 | 0% | 30 | 30 | $0.00 | |
| 0521F | 0% | 30 | 29 | $0.00 | |
| 3078F | 0% | 16 | 16 | $0.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 19 | 19 | $0.00 |
| 3008F | 0% | 24 | 24 | $0.00 | |
| 1170F | 0% | 118 | 116 | $0.00 | |
| 99443 | 0% | 114 | 104 | $0.00 | |
| 3074F | 0% | 14 | 14 | $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.