Physician
Ortega, Hiram
Ortega, Hiram was paid $100.99 by Medicaid between Jan 2018 and Apr 2021, across 15 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 80% of everything it billed.
33Billing provider infoORTEGA, HIRAM
AGUADA, PR 00602
AGUADA, PR 00602
33aNPI1336125368assigned 12/21/2005
33bProvider typeFamily Medicine Physician
28Total paid$100.99
24GClaims2,502
24DCodes billed15
24AFirst – last monthJan 2018 – Apr 2021
Compared with peers
Next to other Family Medicine Physician providers in Puerto Rico
Rank by total paid#110 of 160
Median peer was paid$1K
This provider vs. median0.1×
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 | 976 | $20.00 | |
| 2019 | 746 | $35.84 | |
| 2020 | 550 | $12.68 | |
| 2021 | 230 | $32.47 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 80% | 1,938 | 1,679 | $80.99 |
| 3074F | 9.9% | 39 | 33 | $10.00 | |
| 3078F | 9.9% | 39 | 33 | $10.00 | |
| 1170F | 0% | 99 | 91 | $0.00 | |
| 1157F | 0% | 40 | 37 | $0.00 | |
| 3008F | 0% | 34 | 29 | $0.00 | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 0% | 50 | 40 | $0.00 |
| 1126F | 0% | 17 | 16 | $0.00 | |
| 1158F | 0% | 99 | 91 | $0.00 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 54 | 52 | $0.00 |
| 99442 | 0% | 25 | 25 | $0.00 | |
| 4035F | 0% | 17 | 16 | $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.