Casanova, Heriberto

Casanova, Heriberto was paid $139K by Medicaid between Aug 2021 and Feb 2024, across 6 billing codes. Its largest line is 99223, Prolong inpt eval add15 m — 82% of everything it billed.

33Billing provider infoCASANOVA, HERIBERTO
SAN JUAN, PR 00927

33aNPI1275829459assigned 06/25/2011

33bProvider typeSurgery Physician

28Total paid$139K

24GClaims1,175

24DCodes billed6

24AFirst – last monthAug 2021 – Feb 2024

Compared with peers

Next to other Surgery Physician providers in Puerto Rico

Rank by total paid#20 of 111

Median peer was paid$28K

This provider vs. median4.9×

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
2021	234	$24K
2022	532	$58K
2023	367	$50K
2024incomplete	42	$7K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99223	Prolong inpt eval add15 m	82%	808	728	$115K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	10%	238	212	$14K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	4.6%	71	60	$6K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	1.6%	29	24	$2K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	17	12	$1K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	<1%	12	12	$558.00

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.