Physician
Abroguena, John Paul
Abroguena, John Paul was paid $558K by Medicaid between Jan 2018 and Dec 2024, across 40 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 55% of everything it billed.
33Billing provider infoABROGUENA, JOHN PAUL
PROVIDENCE, RI 02904
PROVIDENCE, RI 02904
33aNPI1235361080assigned 08/12/2009
33bProvider typeFamily Medicine Physician
28Total paid$558K
24GClaims13,864
24DCodes billed40
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Medicine Physician providers in Rhode Island
Rank by total paid#17 of 220
Median peer was paid$33K
This provider vs. median17×
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 | 4,510 | $163K | |
| 2019 | 299 | $12K | |
| 2020 | 2,009 | $80K | |
| 2021 | 2,131 | $88K | |
| 2022 | 1,692 | $74K | |
| 2023 | 1,834 | $78K | |
| 2024incomplete | 1,389 | $63K |
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 | 55% | 6,466 | 5,851 | $304K |
| 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 | 20% | 1,723 | 1,617 | $112K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.0% | 1,830 | 1,726 | $17K |
| G0467 | Community health center visit, returning patientFederally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | 2.9% | 92 | 72 | $16K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 2.9% | 232 | 226 | $16K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 2.2% | 209 | 206 | $12K |
| 87428 | 2.0% | 201 | 195 | $11K | |
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 1.9% | 64 | 53 | $10K |
| T1017 | Case management, billed per 15 minutesTargeted case management, each 15 minutes | 1.4% | 148 | 147 | $8K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.1% | 212 | 199 | $6K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 1.1% | 399 | 374 | $6K |
| 99385 | <1% | 49 | 49 | $4K |
28 more codes
| 0012A | <1% | 95 | $4K | |
| 99051 | <1% | 161 | $4K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 514 | $3K |
| 99460 | <1% | 70 | $3K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 57 | $3K |
| 0011A | <1% | 113 | $3K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 42 | $2K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 103 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 25 | $2K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 87 | $1K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 16 | $887.52 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 12 | $775.20 |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 77 | $756.80 |
| T1016 | Case management, each 15 minutes | <1% | 46 | $646.00 |
| 0002A | <1% | 13 | $524.89 | |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 14 | $456.04 |
| 99173 | <1% | 85 | $430.81 | |
| 96160 | <1% | 103 | $339.96 | |
| 99442 | <1% | 17 | $287.12 | |
| 93000 | <1% | 18 | $224.35 | |
| 86580 | <1% | 42 | $217.56 | |
| 82962 | <1% | 116 | $200.63 | |
| 94760 | <1% | 63 | $155.21 | |
| 81002 | <1% | 75 | $154.42 | |
| 81025 | <1% | 27 | $141.72 | |
| 90686 | <1% | 222 | $122.83 | |
| 99441 | <1% | 13 | $120.12 | |
| 90715 | <1% | 13 | $0.45 |
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.