Medina-Rivera, Rafael

Medina-Rivera, Rafael was paid $758K by Medicaid between Jan 2018 and Dec 2024, across 7 billing codes. Its largest line is 99070, — 29% of everything it billed.

33Billing provider infoMEDINA-RIVERA, RAFAEL
AIBONITO, PR 00705

33aNPI1568453157assigned 11/02/2005

33bProvider typeGastroenterology Physician

28Total paid$758K

24GClaims7,388

24DCodes billed7

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Gastroenterology Physician providers in Puerto Rico

Rank by total paid#17 of 107

Median peer was paid$47K

This provider vs. median16×

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	1,402	$153K
2019	1,590	$181K
2020	988	$96K
2021	836	$81K
2022	862	$80K
2023	1,091	$115K
2024incomplete	619	$51K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99070		29%	1,921	1,540	$220K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	21%	466	414	$160K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	17%	2,627	2,226	$128K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	15%	2,017	1,788	$116K
45380	Colonoscopy, flexible; with biopsy, single or multiple	15%	310	290	$115K
45385	Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s)	2.7%	34	28	$20K
G0500	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate)	0%	13	12	$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.