Physician
Martinez Lebron, Heriberto
Martinez Lebron, Heriberto was paid $1.43M by Medicaid between Jan 2018 and Dec 2024, across 14 billing codes. Its largest line is 92012, Ophthalmological services: medical examination and evaluation, intermediate, established patient — 59% of everything it billed.
33Billing provider infoMARTINEZ LEBRON, HERIBERTO
GUAYAMA, PR 00784
GUAYAMA, PR 00784
33aNPI1538279617assigned 08/30/2006
33bProvider typeOphthalmology Physician
28Total paid$1.43M
24GClaims27,880
24DCodes billed14
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Ophthalmology Physician providers in Puerto Rico
Rank by total paid#11 of 141
Median peer was paid$163K
This provider vs. median8.8×
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 | 5,728 | $285K | |
| 2019 | 4,801 | $211K | |
| 2020 | 4,298 | $191K | |
| 2021 | 4,560 | $242K | |
| 2022 | 4,086 | $221K | |
| 2023 | 3,807 | $242K | |
| 2024incomplete | 600 | $38K |
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 | 59% | 13,666 | 12,021 | $845K |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 14% | 1,738 | 1,638 | $199K |
| 92015 | Determination of refractive state | 12% | 5,400 | 4,942 | $178K |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | 5.7% | 118 | 117 | $81K |
| 92002 | 2.0% | 756 | 743 | $28K | |
| 92202 | 1.6% | 1,784 | 1,535 | $23K | |
| 92020 | 1.5% | 1,501 | 1,349 | $21K | |
| 92225 | 1.1% | 725 | 362 | $16K | |
| 76519 | <1% | 498 | 461 | $13K | |
| 92226 | <1% | 942 | 472 | $12K | |
| 65426 | <1% | 14 | 14 | $6K | |
| 92201 | <1% | 612 | 536 | $6K |
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.