Managed care
Organizacion De Medicos Especialita Y Generales Asociados C S P Omega
Organizacion De Medicos Especialita Y Generales Asociados C S P Omega was paid $250K by Medicaid between Jan 2018 and Dec 2024, across 121 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 33% of everything it billed.
33Billing provider infoORGANIZACION DE MEDICOS ESPECIALITA Y GENERALES ASOCIADOS C S P OMEGA
SAN GERMAN, PR 00683
SAN GERMAN, PR 00683
33aNPI1407823495assigned 03/08/2006
33bProvider typeExclusive Provider Organization
28Total paid$250K
24GClaims844,176
24DCodes billed121
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Exclusive Provider Organization providers in Puerto Rico
Rank by total paid#10 of 19
Median peer was paid$250K
This provider vs. median1.0×
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 | 112,533 | $8K | |
| 2019 | 50,744 | $10K | |
| 2020 | 45,495 | $25K | |
| 2021 | 92,756 | $30K | |
| 2022 | 96,039 | $39K | |
| 2023 | 169,717 | $63K | |
| 2024incomplete | 276,892 | $74K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 33% | 7,245 | 6,122 | $84K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 27% | 226,752 | 153,678 | $68K |
| 96160 | 26% | 14,605 | 9,860 | $66K | |
| 99441 | 3.6% | 40,452 | 31,028 | $9K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 3.5% | 91,935 | 59,691 | $9K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.4% | 8,194 | 5,832 | $4K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 2,133 | 2,009 | $2K |
| 99442 | <1% | 10,553 | 8,893 | $1K | |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | <1% | 194 | 155 | $1K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 12,673 | 8,978 | $919.63 |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | <1% | 87 | 84 | $861.11 |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 12,089 | 7,172 | $796.16 |
109 more codes
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 13 | $756.86 |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 3,147 | $738.20 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 8,385 | $670.86 |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 739 | $393.80 |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 307 | $382.30 |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 3,103 | $346.81 |
| 99221 | <1% | 423 | $302.48 | |
| 88142 | <1% | 1,049 | $258.39 | |
| 88174 | <1% | 192 | $142.66 | |
| 97803 | <1% | 2,441 | $130.60 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 2,704 | $102.00 |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 4,794 | $94.28 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 1,120 | $75.93 |
| 94664 | <1% | 1,366 | $75.00 | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 2,770 | $61.50 |
| 96127 | <1% | 10,477 | $42.53 | |
| 86580 | <1% | 3,810 | $40.68 | |
| 94760 | <1% | 2,677 | $25.00 | |
| 99401 | <1% | 2,670 | $20.54 | |
| 99368 | <1% | 2,518 | $20.00 | |
| 80061 | Lipid panel | <1% | 790 | $18.24 |
| 92551 | <1% | 3,332 | $12.00 | |
| 99173 | <1% | 3,913 | $1.60 | |
| 3510F | <1% | 955 | $0.01 | |
| 3049F | 0% | 442 | $0.00 | |
| 3008F | 0% | 42,352 | $0.00 | |
| 3074F | 0% | 56,674 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 9,454 | $0.00 |
| 1126F | 0% | 16,805 | $0.00 | |
| 99383 | 0% | 311 | $0.00 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 0% | 958 | $0.00 |
| 1125F | 0% | 4,903 | $0.00 | |
| 1157F | 0% | 5,141 | $0.00 | |
| 1030F | 0% | 3,747 | $0.00 | |
| 3079F | 0% | 5,780 | $0.00 | |
| 3017F | 0% | 2,476 | $0.00 | |
| 3061F | 0% | 822 | $0.00 | |
| 3048F | 0% | 1,677 | $0.00 | |
| 1111F | 0% | 792 | $0.00 | |
| 3080F | 0% | 1,567 | $0.00 | |
| 1170F | 0% | 16,798 | $0.00 | |
| 3044F | 0% | 1,785 | $0.00 | |
| 1036F | 0% | 3,247 | $0.00 | |
| 3075F | 0% | 5,576 | $0.00 | |
| 3292F | 0% | 1,625 | $0.00 | |
| G0328 | Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous | 0% | 139 | $0.00 |
| 2010F | 0% | 2,446 | $0.00 | |
| 4010F | 0% | 2,032 | $0.00 | |
| 93000 | 0% | 735 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 603 | $0.00 |
| 3011F | 0% | 109 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 132 | $0.00 |
| 99384 | 0% | 406 | $0.00 | |
| 96150 | 0% | 153 | $0.00 | |
| 3072F | 0% | 377 | $0.00 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 0% | 81 | $0.00 |
| 3066F | 0% | 410 | $0.00 | |
| 3014F | 0% | 694 | $0.00 | |
| 99386 | 0% | 170 | $0.00 | |
| 87590 | 0% | 44 | $0.00 | |
| 1101F | 0% | 1,575 | $0.00 | |
| 1000F | 0% | 144 | $0.00 | |
| 1022F | 0% | 2,878 | $0.00 | |
| 99385 | 0% | 293 | $0.00 | |
| 99090 | 0% | 57 | $0.00 | |
| 2023F | 0% | 231 | $0.00 | |
| 96161 | 0% | 85 | $0.00 | |
| 87490 | 0% | 45 | $0.00 | |
| 0509F | 0% | 93 | $0.00 | |
| 4008F | 0% | 13 | $0.00 | |
| 86701 | 0% | 123 | $0.00 | |
| 4086F | 0% | 14 | $0.00 | |
| V5008 | Hearing screening | 0% | 81 | $0.00 |
| 2000F | 0% | 115 | $0.00 | |
| 85018 | 0% | 55 | $0.00 | |
| 96156 | 0% | 88 | $0.00 | |
| 1160F | 0% | 27,543 | $0.00 | |
| 3078F | 0% | 61,156 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 521 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 3,852 | $0.00 |
| S9441 | Asthma education, non-physician provider, per session | 0% | 1,441 | $0.00 |
| 3077F | 0% | 4,577 | $0.00 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 1,168 | $0.00 |
| 99408 | 0% | 4,804 | $0.00 | |
| 1158F | 0% | 7,390 | $0.00 | |
| 1159F | 0% | 29,916 | $0.00 | |
| 3088F | 0% | 116 | $0.00 | |
| 0521F | 0% | 607 | $0.00 | |
| 3725F | 0% | 7,469 | $0.00 | |
| 4013F | 0% | 953 | $0.00 | |
| G0451 | Development testing, with interpretation and report, per standardized instrument form | 0% | 223 | $0.00 |
| 1090F | 0% | 1,253 | $0.00 | |
| 99201 | 0% | 79 | $0.00 | |
| 4035F | 0% | 1,349 | $0.00 | |
| 3045F | 0% | 219 | $0.00 | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 0% | 41 | $0.00 |
| 2028F | 0% | 149 | $0.00 | |
| 99397 | 0% | 103 | $0.00 | |
| 83655 | 0% | 359 | $0.00 | |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | 0% | 53 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 426 | $0.00 |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 63 | $0.00 |
| 90846 | Family psychotherapy without the patient present, 50 minutes | 0% | 33 | $0.00 |
| 86703 | 0% | 29 | $0.00 | |
| 3050F | 0% | 74 | $0.00 | |
| 3095F | 0% | 109 | $0.00 | |
| 99382 | 0% | 59 | $0.00 | |
| 3288F | 0% | 47 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 35 | $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.
From NPPES
Who's on the registration
Authorized officialPEREZ BONILLA, MIGUEL (PRESIDENT)