Instituto Medico Familiar INC
Instituto Medico Familiar INC was paid $1.16M by Medicaid between Jan 2018 and Dec 2024, across 62 billing codes. Its largest line is S9097, Home visit for wound care — 65% of everything it billed.
33Billing provider infoINSTITUTO MEDICO FAMILIAR INC
CANOVANAS, PR 00729
CANOVANAS, PR 00729
33aNPI1205948817assigned 08/31/2006
33bProvider typeLegal Medicine
28Total paid$1.16M
24GClaims318,745
24DCodes billed62
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Legal Medicine providers in Puerto Rico
Rank by total paid#1 of 14
Median peer was paid$119.54
This provider vs. median9,671×
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 | 19,153 | $48K | |
| 2019 | 26,496 | $52K | |
| 2020 | 34,457 | $116K | |
| 2021 | 55,043 | $292K | |
| 2022 | 51,946 | $209K | |
| 2023 | 73,990 | $309K | |
| 2024incomplete | 57,660 | $132K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| S9097 | Home visit for wound care | 65% | 15,360 | 2,128 | $746K |
| 99345 | Prolong home eval add 15m | 13% | 2,615 | 536 | $145K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.6% | 90,921 | 79,826 | $87K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 6.3% | 2,201 | 640 | $72K |
| T1002 | Rn services, up to 15 minutes | 3.5% | 1,462 | 246 | $41K |
| 99337 | 1.2% | 2,521 | 2,080 | $13K | |
| 99441 | <1% | 22,548 | 19,774 | $11K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 912 | 874 | $7K |
| T1030 | Nursing care, in the home, by registered nurse, per diem | <1% | 74 | 57 | $5K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 7,298 | 5,946 | $5K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 5,739 | 4,443 | $3K |
| 0002A | <1% | 128 | 88 | $3K |
50 more codes
| 99443 | <1% | 159 | $3K | |
| 96365 | Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour | <1% | 744 | $3K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 5,274 | $3K |
| 99348 | <1% | 1,111 | $2K | |
| 0001A | <1% | 137 | $2K | |
| 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 | <1% | 18,057 | $1K |
| 99336 | <1% | 14 | $1K | |
| 0003A | <1% | 59 | $1K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 1,322 | $531.52 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 1,234 | $408.00 |
| 90837 | Psychotherapy session, about an hour | <1% | 1,890 | $55.00 |
| 96127 | <1% | 1,097 | $52.39 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 201 | $32.00 |
| 96150 | <1% | 95 | $28.11 | |
| 99401 | <1% | 891 | $20.54 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,535 | $15.26 |
| 96160 | <1% | 983 | $2.26 | |
| 3008F | <1% | 36,786 | $0.59 | |
| 3078F | <1% | 32,580 | $0.56 | |
| 3075F | <1% | 9,917 | $0.34 | |
| 3074F | <1% | 27,721 | $0.24 | |
| 3079F | <1% | 4,823 | $0.01 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 368 | $0.00 |
| 99050 | 0% | 837 | $0.00 | |
| 1170F | 0% | 3,137 | $0.00 | |
| 3017F | 0% | 929 | $0.00 | |
| 99349 | 0% | 139 | $0.00 | |
| 3044F | 0% | 620 | $0.00 | |
| 99368 | 0% | 160 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 50 | $0.00 |
| 99350 | Prolong home eval add 15m | 0% | 530 | $0.00 |
| 3014F | 0% | 430 | $0.00 | |
| 3011F | 0% | 160 | $0.00 | |
| 99241 | 0% | 14 | $0.00 | |
| 1111F | 0% | 61 | $0.00 | |
| 3061F | 0% | 39 | $0.00 | |
| 3048F | 0% | 46 | $0.00 | |
| 3049F | 0% | 15 | $0.00 | |
| 4037F | 0% | 28 | $0.00 | |
| 1160F | 0% | 3,144 | $0.00 | |
| 2014F | 0% | 3,087 | $0.00 | |
| 90791 | Psychiatric diagnostic evaluation | 0% | 262 | $0.00 |
| 1159F | 0% | 3,138 | $0.00 | |
| 90658 | 0% | 15 | $0.00 | |
| 1158F | 0% | 2,750 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 145 | $0.00 |
| 96152 | 0% | 125 | $0.00 | |
| 3077F | 0% | 66 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 12 | $0.00 |
| 3050F | 0% | 29 | $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 officialGARCIA, OSCAR (PRESIDENTE)
| Provider | Location | Paid |
|---|---|---|
| Potential Home Health Care INC. | Miami, FL | $6.20M |
| Oscar J Garcia MD PA | Edinburg, TX | $46K |
| Instituto Medico Familiar Del Este | Canovanas, PR | $112.50 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.