Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Clinic

Puerto Rican Organization to Motivate Enlighten and Serve Addicts INC

Puerto Rican Organization to Motivate Enlighten and Serve Addicts INC was paid $64.21M by Medicaid between Jan 2018 and Dec 2024, across 65 billing codes. Its largest line is H0020, Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) — 60% of everything it billed.

33Billing provider infoPUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS INC
BRONX, NY 10457
33aNPI1407830946assigned 11/29/2005
28Total paid$64.21M
24GClaims1,748,781
24DCodes billed65
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Federally Qualified Health Center (FQHC) providers in New York

Rank by total paid#5 of 158
Median peer was paid$1.73M
This provider vs. median37×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Entity ProliferationAuthorized official GATELL, VICKY controls 14+ related entities in our dataset. Read more
Box 24A · Dates of service

Paid by month

$0$500K$1.0M$1.5M2018201920202021202220232024
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
YearClaimsPaid
201827,493$1.16M
2019116,602$4.80M
2020356,672$12.39M
2021385,469$13.56M
2022356,093$13.61M
2023329,722$12.86M
2024incomplete176,730$5.83M
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
H0020 Alcohol and/or drug services; methadone administration and/or service (provision of the drug by a licensed program) 60% 1,418,926 63,400 $38.78M
90834 Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient 10% 49,838 29,680 $6.72M
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 9.8% 85,450 65,287 $6.27M
90832 Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient 6.7% 41,705 26,739 $4.29M
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 4.0% 27,292 21,285 $2.55M
H0005 Alcohol and/or drug services; group counseling by a clinician 3.0% 35,609 8,754 $1.96M
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 1.3% 10,856 8,587 $863K
90791 Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation <1% 2,674 2,586 $452K
H0038 Self-help/peer services, per 15 minutes <1% 8,682 5,284 $362K
H0004 Behavioral health counseling and therapy, per 15 minutes <1% 7,512 6,282 $359K
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 2,740 2,608 $297K
99442 <1% 4,341 3,206 $172K
53 more codes
99407 <1% 3,651 $166K
G2067 Medication assisted treatment, methadone; weekly bundle including dispensing and/or administration, substance use counseling, individual and group therapy, and toxicology testing, if performed (provision of the services by a medicare-enrolled opioid treatment program) <1% 4,025 $152K
90792 Psychiatric diagnostic evaluation with medical services <1% 783 $143K
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 1,307 $135K
99385 <1% 533 $62K
G2078 Take-home supply of methadone; up to 7 additional day supply (provision of the services by a medicare-enrolled opioid treatment program); list separately in addition to code for primary procedure <1% 3,652 $60K
99386 <1% 475 $59K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 2,315 $49K
99204 Doctor's office visit, new patient (more involved) <1% 416 $43K
H0050 Alcohol and/or drug services, brief intervention, per 15 minutes <1% 853 $41K
96127 <1% 17,473 $38K
H0049 Alcohol and/or drug screening <1% 784 $37K
99441 <1% 821 $23K
90882 <1% 502 $16K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,875 $15K
99051 <1% 1,337 $13K
98968 <1% 93 $10K
0012A <1% 281 $9K
90686 <1% 654 $9K
36415 Collection of venous blood by venipuncture <1% 5,649 $8K
0011A <1% 359 $8K
99203 Doctor's office visit, new patient (routine) <1% 43 $5K
0064A <1% 121 $4K
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) <1% 88 $4K
99215 Doctor's office visit, returning patient (complex) <1% 28 $3K
90837 Psychotherapy session, about an hour <1% 34 $3K
92551 <1% 40 $3K
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) <1% 24 $2K
99205 Prolong outpt/office vis <1% 13 $2K
99173 <1% 31 $2K
H0001 Alcohol and/or drug assessment <1% 12 $2K
92014 Ophthalmological services: medical examination and evaluation, comprehensive, established patient <1% 45 $1K
90682 <1% 54 $1K
90460 Immunization administration through 18 years of age via any route, first or only component <1% 128 $1K
90472 Immunization administration, each additional vaccine (list separately) <1% 94 $1K
99484 <1% 58 $1K
92015 Determination of refractive state <1% 128 $1K
90688 <1% 61 $1K
90656 <1% 84 $866.78
0031A <1% 26 $554.01
90674 <1% 19 $433.74
90715 <1% 26 $146.83
90658 <1% 13 $145.54
99490 Ccm add 20min <1% 12 $99.89
3079F <1% 482 $10.00
3008F <1% 1,703 $4.50
3078F 0% 608 $0.00
3077F 0% 521 $0.00
3074F 0% 474 $0.00
3080F 0% 101 $0.00
1220F 0% 15 $0.00
3075F 0% 103 $0.00
3044F 0% 129 $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 officialGATELL, VICKY (CHIEF FINANCIAL OFFICER)
Parent organizationPUERTO RICAN ORGANIZATION TO MOTIVATE ENLIGHTEN AND SERVE ADDICTS INC
Same official

Other billing entities under GATELL, VICKY

Full network →

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.