Avila Ornelas, Jose

Avila Ornelas, Jose was paid $33K by Medicaid between Dec 2023 and Jul 2024, across 5 billing codes. Its largest line is 96365, Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour — 38% of everything it billed.

33Billing provider infoAVILA ORNELAS, JOSE
CAGUAS, PR 00725

33aNPI1467868927assigned 07/06/2014

33bProvider typeNeurology Physician

28Total paid$33K

24GClaims583

24DCodes billed5

24AFirst – last monthDec 2023 – Jul 2024

Compared with peers

Next to other Neurology Physician providers in Puerto Rico

Rank by total paid#21 of 45

Median peer was paid$16K

This provider vs. median2.1×

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
2023	39	$2K
2024incomplete	544	$31K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour	38%	237	198	$12K
Q0081	Infusion therapy, using other than chemotherapeutic drugs, per visit	26%	131	118	$9K
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	25%	177	150	$8K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	11%	25	17	$4K
99211	Office or other outpatient visit for the evaluation and management of an established patient, minimal severity	<1%	13	13	$113.58

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.