Pagan Mercado, Ketsy

Pagan Mercado, Ketsy was paid $134K by Medicaid between Jan 2018 and Jul 2024, across 18 billing codes. Its largest line is 99284, emergency room visit (serious) — 44% of everything it billed.

33Billing provider infoPAGAN MERCADO, KETSY
GURABO, PR 00778

33aNPI1215906987assigned 03/16/2006

33bProvider typePediatrics Physician

28Total paid$134K

24GClaims2,861

24DCodes billed18

24AFirst – last monthJan 2018 – Jul 2024

Compared with peers

Next to other Pediatrics Physician providers in Puerto Rico

Rank by total paid#38 of 194

Median peer was paid$7K

This provider vs. median20×

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	71	$3K
2019	317	$10K
2020	35	$3K
2021	396	$24K
2022	780	$56K
2023	1,093	$33K
2024incomplete	169	$5K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	44%	901	850	$60K
99235		16%	510	474	$22K
99219		9.7%	148	123	$13K
99238	Hospital discharge day management, 30 minutes or less	8.4%	373	337	$11K
99285	Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life	7.8%	203	198	$10K
99221		6.8%	171	148	$9K
99223	Prolong inpt eval add15 m	3.3%	36	31	$4K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	1.5%	37	32	$2K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	<1%	18	18	$837.00
99255		<1%	20	15	$745.96
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	59	55	$349.40
96360	Intravenous infusion, hydration; initial, 31 minutes to 1 hour	<1%	32	29	$186.40

6 more codes

94664		<1%	17	$101.76
96374	Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance	<1%	16	$85.86
99225		<1%	28	$38.79
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	40	$30.00
1501F		<1%	88	$1.00
1119F		0%	164	$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.