Physician
Flores, Carlos
Flores, Carlos was paid $179K by Medicaid between Mar 2018 and Apr 2024, across 28 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 35% of everything it billed.
33Billing provider infoFLORES, CARLOS
NEW CASTLE, PA 16105
NEW CASTLE, PA 16105
33aNPI1396725594assigned 01/23/2006
33bProvider typePediatric Adolescent Medicine Physician
28Total paid$179K
24GClaims9,311
24DCodes billed28
24AFirst – last monthMar 2018 – Apr 2024
Compared with peers
Next to other Pediatric Adolescent Medicine Physician providers in Pennsylvania
Rank by total paid#15 of 44
Median peer was paid$39K
This provider vs. median4.6×
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 | 14 | $451.20 | |
| 2020 | 119 | $2K | |
| 2021 | 2,918 | $67K | |
| 2022 | 3,794 | $75K | |
| 2023 | 2,188 | $30K | |
| 2024incomplete | 278 | $4K |
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 | 35% | 1,907 | 1,750 | $62K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | 21% | 1,461 | 337 | $37K |
| 99222 | Initial hospital care, per day, moderate complexity | 13% | 267 | 263 | $23K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 8.8% | 580 | 573 | $16K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 6.1% | 116 | 116 | $11K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.9% | 71 | 71 | $7K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 3.9% | 73 | 73 | $7K |
| 99238 | Hospital discharge day management, 30 minutes or less | 2.5% | 237 | 232 | $5K |
| 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 | 1.2% | 42 | 41 | $2K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.1% | 239 | 234 | $2K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 254 | 251 | $2K |
| G0008 | Administration of influenza virus vaccine | <1% | 112 | 112 | $1K |
16 more codes
| 99188 | <1% | 57 | $1K | |
| 99221 | <1% | 33 | $1K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 12 | $927.50 |
| 90656 | <1% | 76 | $784.50 | |
| 90670 | <1% | 24 | $241.00 | |
| 92552 | <1% | 275 | $224.63 | |
| 99173 | <1% | 329 | $134.40 | |
| 90648 | <1% | 12 | $132.00 | |
| 96160 | <1% | 205 | $67.89 | |
| 96127 | <1% | 117 | $37.30 | |
| 96161 | <1% | 12 | $14.97 | |
| 3079F | 0% | 89 | $0.00 | |
| 3074F | 0% | 1,441 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 39 | $0.00 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 14 | $0.00 |
| 3078F | 0% | 1,217 | $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.