Montalvo Nephrology Institute PSC
Montalvo Nephrology Institute PSC was paid $474K by Medicaid between Jan 2018 and Nov 2024, across 5 billing codes. Its largest line is 90960, End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits — 71% of everything it billed.
33Billing provider infoMONTALVO NEPHROLOGY INSTITUTE PSC
CANOVANAS, PR 00729
CANOVANAS, PR 00729
33aNPI1265692412assigned 06/11/2008
33bProvider typeSpecialist
28Total paid$474K
24GClaims3,447
24DCodes billed5
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Specialist providers in Puerto Rico
Rank by total paid#49 of 316
Median peer was paid$26K
This provider vs. median19×
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 | 411 | $29K | |
| 2019 | 529 | $35K | |
| 2020 | 385 | $47K | |
| 2021 | 665 | $79K | |
| 2022 | 487 | $86K | |
| 2023 | 502 | $93K | |
| 2024incomplete | 468 | $105K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 90960 | End-stage renal disease related services monthly, for patients 20 years and older, with 4 or more face-to-face visits | 71% | 1,471 | 1,119 | $339K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 11% | 1,105 | 985 | $54K |
| 90961 | 8.9% | 373 | 345 | $42K | |
| 99223 | Prolong inpt eval add15 m | 6.9% | 355 | 293 | $33K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 1.3% | 143 | 59 | $6K |
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 officialMONTALVO-BURKE, LISANDRO (PRESIDENT)