Managed care
Costa Este Medical Services Corp
Costa Este Medical Services Corp was paid $656K by Medicaid between Jan 2018 and Dec 2024, across 63 billing codes. Its largest line is 99345, Prolong home eval add 15m — 43% of everything it billed.
33Billing provider infoCOSTA ESTE MEDICAL SERVICES CORP
FAJARDO, PR 00738
FAJARDO, PR 00738
33aNPI1548430689assigned 03/05/2008
33bProvider typeHealth Maintenance Organization
28Total paid$656K
24GClaims76,234
24DCodes billed63
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Health Maintenance Organization providers in Puerto Rico
Rank by total paid#3 of 37
Median peer was paid$25K
This provider vs. median26×
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 | 39,219 | $102K | |
| 2019 | 13,339 | $88K | |
| 2020 | 3,067 | $115K | |
| 2021 | 4,683 | $93K | |
| 2022 | 4,458 | $73K | |
| 2023 | 6,974 | $150K | |
| 2024incomplete | 4,494 | $35K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99345 | Prolong home eval add 15m | 43% | 4,584 | 777 | $280K |
| S9097 | Home visit for wound care | 39% | 3,944 | 681 | $256K |
| T1002 | Rn services, up to 15 minutes | 6.1% | 817 | 154 | $40K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 5.0% | 1,138 | 416 | $33K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.3% | 36,534 | 31,189 | $15K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.9% | 8,956 | 7,787 | $12K |
| 96160 | 1.6% | 324 | 308 | $11K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 1,099 | 1,067 | $4K |
| 99205 | Prolong outpt/office vis | <1% | 369 | 364 | $2K |
| 99341 | <1% | 12 | 12 | $840.00 | |
| 99050 | <1% | 81 | 78 | $652.00 | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | <1% | 77 | 77 | $434.00 |
51 more codes
| 99201 | <1% | 15 | $225.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 654 | $83.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 2,168 | $44.12 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 2,540 | $24.31 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 406 | $0.16 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 1,024 | $0.12 |
| 96152 | 0% | 241 | $0.00 | |
| 1160F | 0% | 554 | $0.00 | |
| 1158F | 0% | 151 | $0.00 | |
| 80061 | Lipid panel | 0% | 738 | $0.00 |
| 2028F | 0% | 159 | $0.00 | |
| 1159F | 0% | 474 | $0.00 | |
| 6080F | 0% | 136 | $0.00 | |
| 3078F | 0% | 857 | $0.00 | |
| 4035F | 0% | 24 | $0.00 | |
| 0518F | 0% | 193 | $0.00 | |
| 3725F | 0% | 180 | $0.00 | |
| 99442 | 0% | 40 | $0.00 | |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 81 | $0.00 |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 26 | $0.00 |
| 84439 | 0% | 17 | $0.00 | |
| 0521F | 0% | 24 | $0.00 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | 0% | 1,004 | $0.00 |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 676 | $0.00 |
| 3074F | 0% | 907 | $0.00 | |
| 3008F | 0% | 996 | $0.00 | |
| 84153 | 0% | 46 | $0.00 | |
| 99383 | 0% | 15 | $0.00 | |
| 1126F | 0% | 229 | $0.00 | |
| 80050 | General health panel | 0% | 299 | $0.00 |
| 3075F | 0% | 172 | $0.00 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 338 | $0.00 |
| 80053 | Comprehensive metabolic panel | 0% | 620 | $0.00 |
| 81000 | 0% | 761 | $0.00 | |
| 99443 | 0% | 15 | $0.00 | |
| 2000F | 0% | 28 | $0.00 | |
| 3079F | 0% | 240 | $0.00 | |
| 87110 | 0% | 62 | $0.00 | |
| 99441 | 0% | 136 | $0.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 308 | $0.00 |
| 1170F | 0% | 219 | $0.00 | |
| 80069 | 0% | 25 | $0.00 | |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 201 | $0.00 |
| 87086 | Culture, bacterial; quantitative colony count, urine | 0% | 41 | $0.00 |
| 82270 | 0% | 87 | $0.00 | |
| 84436 | 0% | 18 | $0.00 | |
| 96150 | 0% | 51 | $0.00 | |
| 99384 | 0% | 12 | $0.00 | |
| 1125F | 0% | 47 | $0.00 | |
| 84479 | 0% | 16 | $0.00 | |
| 2010F | 0% | 28 | $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.
From NPPES
Who's on the registration
Authorized officialGONZALEZ, ISMARY (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Costa Este Medical Services LLC | Fajardo, PR | $198K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.