Plenos, Rafael

Plenos, Rafael was paid $72K by Medicaid between Oct 2021 and Dec 2024, across 4 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 58% of everything it billed.

33Billing provider infoPLENOS, RAFAEL
DEKALB, IL 60115

33aNPI1437753431assigned 11/30/2020

33bProvider typeNurse Practitioner

28Total paid$72K

24GClaims813

24DCodes billed4

24AFirst – last monthOct 2021 – Dec 2024

Compared with peers

Next to other Nurse Practitioner providers in Illinois

Rank by total paid#430 of 1,687

Median peer was paid$22K

This provider vs. median3.3×

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
2021	32	$3K
2022	163	$15K
2023	282	$23K
2024incomplete	336	$31K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	58%	361	334	$42K
99284	Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity	36%	351	315	$26K
99283	Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity	2.9%	55	54	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	2.6%	46	46	$2K

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.