Physician
Carlo, Simon
Carlo, Simon was paid $1K by Medicaid between Jan 2018 and Nov 2024, across 11 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 94% of everything it billed.
33Billing provider infoCARLO, SIMON
HORMIGUEROS, PR 00660
HORMIGUEROS, PR 00660
33aNPI1548350564assigned 10/13/2006
33bProvider typeGeneral Practice Physician
28Total paid$1K
24GClaims2,203
24DCodes billed11
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other General Practice Physician providers in Puerto Rico
Rank by total paid#666 of 1,195
Median peer was paid$2K
This provider vs. median0.6×
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 | 441 | $0.00 | |
| 2021 | 123 | $838.02 | |
| 2022 | 14 | $0.00 | |
| 2023 | 840 | $302.51 | |
| 2024incomplete | 785 | $0.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 94% | 402 | 263 | $1K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.1% | 513 | 291 | $69.26 |
| 3074F | 0% | 434 | 252 | $0.00 | |
| 1126F | 0% | 16 | 16 | $0.00 | |
| 3008F | 0% | 54 | 30 | $0.00 | |
| 1170F | 0% | 16 | 16 | $0.00 | |
| 3078F | 0% | 282 | 174 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 441 | 162 | $0.00 |
| 1160F | 0% | 16 | 16 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 13 | 13 | $0.00 |
| 1159F | 0% | 16 | 16 | $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.