Lopez Hernandez, Rafael

Lopez Hernandez, Rafael was paid $111K by Medicaid between Nov 2018 and Oct 2024, across 4 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 58% of everything it billed.

33Billing provider infoLOPEZ HERNANDEZ, RAFAEL
SAN JUAN, PR 00919

33aNPI1497740849assigned 09/13/2005

33bProvider typeOrthopaedic Surgery Physician

28Total paid$111K

24GClaims2,458

24DCodes billed4

24AFirst – last monthNov 2018 – Oct 2024

Compared with peers

Next to other Orthopaedic Surgery Physician providers in Puerto Rico

Rank by total paid#32 of 61

Median peer was paid$122K

This provider vs. median0.9×

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	28	$506.00
2019	273	$5K
2020	337	$13K
2021	367	$15K
2022	393	$16K
2023	659	$38K
2024incomplete	401	$24K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	58%	1,327	1,096	$64K
99202	Office or other outpatient visit for the evaluation and management of a new patient, straightforward	24%	437	393	$26K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	9.8%	331	279	$11K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	8.4%	363	281	$9K

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.