Vergara-Gomez, Mark

Vergara-Gomez, Mark was paid $213K by Medicaid between Jan 2018 and Jan 2024, across 6 billing codes. Its largest line is 99291, Critical care, evaluation and management of the critically ill patient, first 30-74 minutes — 82% of everything it billed.

33Billing provider infoVERGARA-GOMEZ, MARK
CAROLINA, PR 00984

33aNPI1619179058assigned 06/05/2007

33bProvider typeCritical Care Medicine (Internal Medicine) Physician

28Total paid$213K

24GClaims2,269

24DCodes billed6

24AFirst – last monthJan 2018 – Jan 2024

Compared with peers

Next to other Critical Care Medicine (Internal Medicine) Physician providers in Puerto Rico

Rank by total paid#5 of 19

Median peer was paid$57K

This provider vs. median3.8×

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	422	$10K
2019	373	$12K
2020	149	$6K
2021	535	$52K
2022	324	$50K
2023	409	$73K
2024incomplete	57	$11K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99291	Critical care, evaluation and management of the critically ill patient, first 30-74 minutes	82%	1,138	241	$175K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	7.7%	650	590	$16K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	5.2%	148	57	$11K
99254		3.8%	230	213	$8K
99253		1.3%	82	75	$3K
94002		<1%	21	14	$797.88

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.