Clinic
R Guillen MD PC
R Guillen MD PC was paid $30K by Medicaid between Jan 2018 and Nov 2024, across 45 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 41% of everything it billed.
33Billing provider infoR GUILLEN MD PC
BRONX, NY 10451
BRONX, NY 10451
33aNPI1467612499assigned 06/12/2008
33bProvider typePrimary Care Clinic/Center
28Total paid$30K
24GClaims39,490
24DCodes billed45
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in New York
Rank by total paid#165 of 242
Median peer was paid$172K
This provider vs. median0.2×
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 | 4,122 | $7K | |
| 2019 | 6,843 | $13K | |
| 2020 | 5,317 | $4K | |
| 2021 | 6,742 | $5K | |
| 2022 | 6,127 | $210.00 | |
| 2023 | 6,155 | $928.67 | |
| 2024incomplete | 4,184 | $105.32 |
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 | 41% | 1,708 | 1,674 | $12K |
| 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% | 1,095 | 1,063 | $8K |
| 3074F | 9.1% | 2,290 | 2,202 | $3K | |
| 3078F | 7.4% | 2,022 | 1,956 | $2K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 6.3% | 442 | 442 | $2K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.5% | 70 | 70 | $755.32 |
| 36415 | Collection of venous blood by venipuncture | 1.6% | 1,509 | 1,503 | $488.03 |
| H0001 | Alcohol and/or drug assessment | 1.4% | 1,172 | 1,172 | $440.39 |
| 3079F | 1.3% | 220 | 208 | $390.08 | |
| 1126F | <1% | 468 | 435 | $185.29 | |
| 90658 | <1% | 78 | 78 | $179.50 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | <1% | 17 | 17 | $150.00 |
33 more codes
| 82962 | <1% | 737 | $80.26 | |
| 1159F | <1% | 1,219 | $80.00 | |
| 94760 | <1% | 68 | $44.97 | |
| G9664 | Patients who are currently statin therapy users or received an order (prescription) for statin therapy | <1% | 876 | $0.60 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | <1% | 1,102 | $0.57 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | <1% | 1,931 | $0.31 |
| 81001 | <1% | 108 | $0.21 | |
| 3008F | <1% | 3,855 | $0.17 | |
| G9622 | Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method | <1% | 1,190 | $0.07 |
| 86803 | <1% | 89 | $0.04 | |
| 86706 | <1% | 87 | $0.03 | |
| 87340 | <1% | 87 | $0.03 | |
| 86704 | <1% | 87 | $0.03 | |
| 86708 | <1% | 87 | $0.03 | |
| 1220F | 0% | 1,065 | $0.00 | |
| G9275 | Documentation that patient is a current non-tobacco user | 0% | 1,276 | $0.00 |
| 81000 | 0% | 24 | $0.00 | |
| 2001F | 0% | 3,483 | $0.00 | |
| 2000F | 0% | 3,405 | $0.00 | |
| 1000F | 0% | 1,027 | $0.00 | |
| 3011F | 0% | 468 | $0.00 | |
| G8420 | Bmi is documented within normal parameters and no follow-up plan is required | 0% | 1,071 | $0.00 |
| 3510F | 0% | 157 | $0.00 | |
| 3061F | 0% | 62 | $0.00 | |
| 3048F | 0% | 65 | $0.00 | |
| 3292F | 0% | 14 | $0.00 | |
| 1033F | 0% | 962 | $0.00 | |
| 3725F | 0% | 1,097 | $0.00 | |
| 3016F | 0% | 1,061 | $0.00 | |
| 1160F | 0% | 578 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 1,023 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 25 | $0.00 |
| G8598 | Aspirin or another antiplatelet therapy used | 0% | 13 | $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 officialGUILLEN, RAFAEL (MEDICAL DOCTOR)