Rocha, Anthony

Rocha, Anthony was paid $1.60M by Medicaid between Jan 2018 and Sep 2022, across 35 billing codes. Its largest line is G0483, Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed — 57% of everything it billed.

Compared with peers

Next to other Family Medicine Physician providers in Rhode Island

Rank by total paid#1 of 220

Median peer was paid$33K

This provider vs. median48×

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	4,133	$347K
2019	4,027	$525K
2020	5,216	$429K
2021	4,720	$192K
2022	2,709	$110K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed	57%	2,658	1,091	$910K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	18%	6,120	5,093	$297K
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	5.7%	1,297	1,137	$91K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed	4.8%	1,083	951	$76K
80307	Drug test(s), presumptive, any number of drug classes; immunoassay	4.6%	1,110	974	$74K
82306	Vitamin D; 25 hydroxy, includes fraction(s), if performed	2.0%	655	582	$32K
80061	Lipid panel	1.5%	869	748	$24K
84443	Thyroid stimulating hormone (TSH)	1.0%	622	533	$17K
82607		1.0%	628	556	$16K
83036	Hemoglobin; glycosylated (A1C)	<1%	744	647	$11K
85025	Blood count; complete (CBC), automated, and automated differential WBC count	<1%	794	698	$10K
84436		<1%	681	593	$8K

23 more codes

99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	<1%	188	$7K
81001		<1%	735	$6K
80048	Basic metabolic panel (calcium, ionized)	<1%	339	$5K
85652		<1%	892	$5K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	44	$3K
80053	Comprehensive metabolic panel	<1%	201	$3K
86803		<1%	74	$2K
36415	Collection of venous blood by venipuncture	<1%	391	$2K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	25	$2K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	<1%	151	$673.82
80050	General health panel	<1%	12	$577.46
80305		<1%	53	$420.61
96372	Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular	<1%	27	$409.55
94640	Pressurized or nonpressurized inhalation treatment for acute airway obstruction	<1%	24	$359.40
G8783	Normal blood pressure reading documented, follow-up not required	<1%	63	$327.97
93000		<1%	19	$296.96
G8510	Screening for depression is documented as negative, a follow-up plan is not required	<1%	59	$280.91
96127		<1%	95	$278.81
87086	Culture, bacterial; quantitative colony count, urine	<1%	20	$208.64
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	13	$134.37
1036F		<1%	19	$115.79
G8483	Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons)	<1%	15	$103.20
J7613	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	<1%	85	$3.44

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.