Hernaez, Edward

Hernaez, Edward was paid $19K by Medicaid between Jan 2018 and May 2023, across 5 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 81% of everything it billed.

33Billing provider infoHERNAEZ, EDWARD
NILES, IL 60714

33aNPI1417001108assigned 01/22/2007

33bProvider typeFamily Medicine Physician

28Total paid$19K

24GClaims434

24DCodes billed5

24AFirst – last monthJan 2018 – May 2023

Compared with peers

Next to other Family Medicine Physician providers in Illinois

Rank by total paid#1,861 of 2,947

Median peer was paid$43K

This provider vs. median0.5×

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	73	$4K
2019	111	$6K
2020	50	$3K
2021	113	$5K
2022	75	$1K
2023	12	$1.54

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	81%	223	188	$16K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	10%	44	39	$2K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	6.2%	98	94	$1K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	2.8%	13	12	$534.13
36415	Collection of venous blood by venipuncture	<1%	56	51	$2.08

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.