Physician
Tous De Jesus, Horacio
Tous De Jesus, Horacio was paid $375K by Medicaid between Jan 2018 and Nov 2024, across 9 billing codes. Its largest line is 92012, Ophthalmological services: medical examination and evaluation, intermediate, established patient — 42% of everything it billed.
33Billing provider infoTOUS DE JESUS, HORACIO
SAN JUAN, PR 00926
SAN JUAN, PR 00926
33aNPI1508064700assigned 07/10/2007
33bProvider typeOphthalmology Physician
28Total paid$375K
24GClaims8,793
24DCodes billed9
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Ophthalmology Physician providers in Puerto Rico
Rank by total paid#45 of 141
Median peer was paid$163K
This provider vs. median2.3×
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 | |
|---|---|---|---|
| 2018 | 1,122 | $27K | |
| 2019 | 1,087 | $35K | |
| 2020 | 1,407 | $51K | |
| 2021 | 1,457 | $70K | |
| 2022 | 1,552 | $78K | |
| 2023 | 1,310 | $71K | |
| 2024incomplete | 858 | $43K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | 42% | 3,187 | 2,665 | $158K |
| 92015 | Determination of refractive state | 16% | 2,459 | 2,251 | $61K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 14% | 470 | 419 | $54K |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 9.8% | 354 | 350 | $37K |
| 92250 | 9.0% | 1,352 | 1,270 | $34K | |
| 92002 | 8.5% | 841 | 767 | $32K | |
| 92225 | <1% | 13 | 13 | $201.20 | |
| 83861 | 0% | 64 | 18 | $0.00 | |
| 99024 | 0% | 53 | 39 | $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.