Figueroa, Rafael
Figueroa, Rafael was paid $733K by Medicaid between Jan 2018 and Nov 2024, across 9 billing codes. Its largest line is 99215, doctor's office visit, returning patient (complex) — 67% of everything it billed.
33Billing provider infoFIGUEROA, RAFAEL
CAGUAS, PR 00726
CAGUAS, PR 00726
33aNPI1205972742assigned 01/30/2007
33bProvider typeSpecialist
28Total paid$733K
24GClaims9,955
24DCodes billed9
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Specialist providers in Puerto Rico
Rank by total paid#31 of 316
Median peer was paid$26K
This provider vs. median29×
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 | 1,052 | $22K | |
| 2019 | 1,552 | $30K | |
| 2020 | 1,659 | $109K | |
| 2021 | 1,671 | $147K | |
| 2022 | 1,108 | $103K | |
| 2023 | 1,159 | $151K | |
| 2024incomplete | 1,754 | $171K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 67% | 6,990 | 5,132 | $491K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 18% | 1,690 | 1,202 | $130K |
| 99205 | Prolong outpt/office vis | 14% | 1,098 | 960 | $103K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | <1% | 17 | 16 | $3K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 22 | 20 | $2K |
| 59025 | Fetal non-stress test | <1% | 52 | 26 | $2K |
| 99223 | Prolong inpt eval add15 m | <1% | 15 | 14 | $1K |
| 76818 | <1% | 12 | 12 | $783.96 | |
| 88142 | <1% | 59 | 58 | $35.02 |
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.