Clinic
Gastrointestinal Diagnostic Clinic of PR, LLC
Gastrointestinal Diagnostic Clinic of PR, LLC was paid $481K by Medicaid between Jan 2018 and Oct 2024, across 11 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 38% of everything it billed.
33Billing provider infoGASTROINTESTINAL DIAGNOSTIC CLINIC OF PR, LLC
MANATI, PR 00674
MANATI, PR 00674
33aNPI1316384100assigned 06/03/2013
33bProvider typeEndoscopy Clinic/Center
28Total paid$481K
24GClaims4,266
24DCodes billed11
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Endoscopy Clinic/Center providers in Puerto Rico
Rank by total paid#1 of 9
Median peer was paid$32K
This provider vs. median15×
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 | 1,271 | $191K | |
| 2019 | 836 | $115K | |
| 2020 | 394 | $22K | |
| 2021 | 374 | $37K | |
| 2022 | 302 | $42K | |
| 2023 | 460 | $38K | |
| 2024incomplete | 629 | $37K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 38% | 465 | 453 | $184K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 35% | 307 | 297 | $167K |
| 99070 | 12% | 2,030 | 1,887 | $59K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.6% | 621 | 589 | $22K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.8% | 258 | 236 | $14K |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | 2.4% | 255 | 189 | $11K |
| 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 | 1.9% | 162 | 162 | $9K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 1.2% | 40 | 39 | $6K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 13 | 13 | $4K |
| 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 | <1% | 101 | 101 | $4K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 14 | 13 | $202.41 |
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 officialRIVERA DE JESUS, SAMUEL (OWNER)