Guzman Ortiz, Carlos

Guzman Ortiz, Carlos was paid $199K by Medicaid between Jan 2018 and Oct 2024, across 8 billing codes. Its largest line is 99222, Initial hospital care, per day, moderate complexity — 47% of everything it billed.

33Billing provider infoGUZMAN ORTIZ, CARLOS
AIBONITO, PR 00705

33aNPI1386712388assigned 11/30/2006

33bProvider typeInfectious Disease Physician

28Total paid$199K

24GClaims2,770

24DCodes billed8

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Infectious Disease Physician providers in Puerto Rico

Rank by total paid#22 of 57

Median peer was paid$106K

This provider vs. median1.9×

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	344	$15K
2019	377	$17K
2020	340	$15K
2021	345	$27K
2022	429	$34K
2023	495	$44K
2024incomplete	440	$47K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99222	Initial hospital care, per day, moderate complexity	47%	848	794	$94K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	21%	804	566	$43K
99253		18%	813	770	$37K
99223	Prolong inpt eval add15 m	5.3%	77	76	$11K
99221		3.8%	105	104	$8K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.9%	67	54	$4K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	1.5%	39	30	$3K
99254		<1%	17	17	$835.00

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.