Managed care
Quality Care Physicians, L.L.C.
Quality Care Physicians, L.L.C. was paid $20K by Medicaid between Jul 2020 and Dec 2024, across 44 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 93% of everything it billed.
33Billing provider infoQUALITY CARE PHYSICIANS, L.L.C.
VEGA ALTA, PR 00692
VEGA ALTA, PR 00692
33aNPI1659771145assigned 09/03/2014
33bProvider typeHealth Maintenance Organization
28Total paid$20K
24GClaims94,936
24DCodes billed44
24AFirst – last monthJul 2020 – Dec 2024
Compared with peers
Next to other Health Maintenance Organization providers in Puerto Rico
Rank by total paid#20 of 37
Median peer was paid$25K
This provider vs. median0.8×
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 | |
|---|---|---|---|
| 2020 | 5,258 | $5K | |
| 2021 | 14,876 | $5K | |
| 2022 | 20,251 | $5K | |
| 2023 | 22,575 | $4K | |
| 2024incomplete | 31,976 | $287.04 |
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 | 93% | 664 | 639 | $18K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 6.4% | 39,229 | 28,608 | $1K |
| 99441 | <1% | 634 | 567 | $154.44 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 194 | 176 | $24.00 |
| 3078F | 0% | 12,164 | 9,547 | $0.00 | |
| 3077F | 0% | 2,476 | 2,025 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 301 | 204 | $0.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 2,676 | 1,864 | $0.00 |
| 99442 | 0% | 95 | 88 | $0.00 | |
| 90630 | 0% | 49 | 49 | $0.00 | |
| 96160 | 0% | 124 | 123 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 398 | 250 | $0.00 |
32 more codes
| 99348 | 0% | 401 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 12 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 1,300 | $0.00 |
| 0071A | 0% | 12 | $0.00 | |
| 1160F | 0% | 55 | $0.00 | |
| 99382 | 0% | 37 | $0.00 | |
| 1158F | 0% | 68 | $0.00 | |
| 1159F | 0% | 55 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 17 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 14 | $0.00 |
| 3074F | 0% | 10,479 | $0.00 | |
| 3079F | 0% | 2,609 | $0.00 | |
| 3008F | 0% | 14,281 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 716 | $0.00 |
| 3075F | 0% | 2,641 | $0.00 | |
| 3044F | 0% | 559 | $0.00 | |
| 99443 | 0% | 404 | $0.00 | |
| 1126F | 0% | 361 | $0.00 | |
| 99385 | 0% | 32 | $0.00 | |
| 3048F | 0% | 286 | $0.00 | |
| 1125F | 0% | 59 | $0.00 | |
| 3080F | 0% | 260 | $0.00 | |
| 3061F | 0% | 338 | $0.00 | |
| 3017F | 0% | 268 | $0.00 | |
| 99384 | 0% | 227 | $0.00 | |
| 3049F | 0% | 59 | $0.00 | |
| 99383 | 0% | 192 | $0.00 | |
| 1157F | 0% | 68 | $0.00 | |
| 2010F | 0% | 35 | $0.00 | |
| 99381 | 0% | 19 | $0.00 | |
| 91307 | 0% | 12 | $0.00 | |
| 1170F | 0% | 56 | $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 BERMSDEZ, LUIS (ACTIVE MEMBER)