Managed care
Metro Medical Health Group, INC.
Metro Medical Health Group, INC. was paid $3K by Medicaid between Nov 2018 and Dec 2024, across 24 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 64% of everything it billed.
33Billing provider infoMETRO MEDICAL HEALTH GROUP, INC.
BAYAMON, PR 00960
BAYAMON, PR 00960
33aNPI1336214485assigned 11/22/2006
33bProvider typeExclusive Provider Organization
28Total paid$3K
24GClaims10,547
24DCodes billed24
24AFirst – last monthNov 2018 – Dec 2024
Compared with peers
Next to other Exclusive Provider Organization providers in Puerto Rico
Rank by total paid#14 of 19
Median peer was paid$250K
This provider vs. median0.0×
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 | 636 | $0.04 | |
| 2019 | 1,983 | $75.50 | |
| 2020 | 795 | $343.96 | |
| 2021 | 639 | $345.39 | |
| 2022 | 871 | $0.00 | |
| 2023 | 2,691 | $2K | |
| 2024incomplete | 2,932 | $0.00 |
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 | 64% | 6,753 | 5,833 | $2K |
| 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 | 36% | 113 | 109 | $1K |
| 1159F | 0% | 175 | 172 | $0.00 | |
| 1160F | 0% | 175 | 172 | $0.00 | |
| 3078F | 0% | 426 | 394 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 55 | 55 | $0.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 71 | 67 | $0.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 33 | 27 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 15 | 12 | $0.00 |
| 96160 | 0% | 20 | 17 | $0.00 | |
| 99442 | 0% | 78 | 76 | $0.00 | |
| 99173 | 0% | 31 | 28 | $0.00 |
12 more codes
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 officialCANDELAS, HECTOR (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Med Caribe CSP | San Juan, PR | $137K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.