Caban Soto, Michael

Caban Soto, Michael was paid $499K by Medicaid between Feb 2018 and Nov 2024, across 5 billing codes. Its largest line is 99284, emergency room visit (serious) — 87% of everything it billed.

33Billing provider infoCABAN SOTO, MICHAEL
AGUADILLA, PR 00603

33aNPI1346387909assigned 01/31/2007

33bProvider typeGeneral Practice Physician

28Total paid$499K

24GClaims8,404

24DCodes billed5

24AFirst – last monthFeb 2018 – Nov 2024

Compared with peers

Next to other General Practice Physician providers in Puerto Rico

Rank by total paid#43 of 1,195

Median peer was paid$2K

This provider vs. median244×

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	318	$5K
2019	646	$5K
2020	274	$3K
2021	237	$7K
2022	1,093	$58K
2023	2,098	$149K
2024incomplete	3,738	$272K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	87%	5,565	4,520	$433K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	12%	2,329	2,030	$58K
99231	Subsequent hospital care, per day, straightforward or low complexity	<1%	137	112	$4K
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only	<1%	335	266	$3K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	<1%	38	32	$1K

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.