Managed care
Carlos G Rivera M.D., PC
Carlos G Rivera M.D., PC was paid $63K by Medicaid between Jan 2018 and Sep 2024, across 1 billing code. Its largest line is 99213, doctor's office visit, returning patient (routine) — 100% of everything it billed.
33Billing provider infoCARLOS G RIVERA M.D., PC
LONG BRANCH, NJ 07740
LONG BRANCH, NJ 07740
33aNPI1447696216assigned 05/20/2013
33bProvider typeExclusive Provider Organization
28Total paid$63K
24GClaims2,376
24DCodes billed1
24AFirst – last monthJan 2018 – Sep 2024
Compared with peers
Next to other Exclusive Provider Organization providers in New Jersey
Rank by total paid#9 of 13
Median peer was paid$159K
This provider vs. median0.4×
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 | 66 | $581.87 | |
| 2019 | 136 | $239.85 | |
| 2020 | 129 | $1K | |
| 2021 | 576 | $17K | |
| 2022 | 581 | $17K | |
| 2023 | 564 | $17K | |
| 2024incomplete | 324 | $10K |
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 | 100% | 2,376 | 1,727 | $63K |
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 officialSWOOPE, SUSAN (MANAGER)