Physician
Oscar Rivera Martinez PSC
Oscar Rivera Martinez PSC was paid $196K by Medicaid between Jan 2018 and Nov 2024, across 14 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 81% of everything it billed.
33Billing provider infoOSCAR RIVERA MARTINEZ PSC
CAGUAS, PR 00725
CAGUAS, PR 00725
33aNPI1669743415assigned 01/24/2012
33bProvider typePulmonary Disease Physician
28Total paid$196K
24GClaims6,423
24DCodes billed14
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Pulmonary Disease Physician providers in Puerto Rico
Rank by total paid#16 of 55
Median peer was paid$68K
This provider vs. median2.9×
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 | 1,896 | $28K | |
| 2019 | 1,830 | $25K | |
| 2020 | 471 | $8K | |
| 2021 | 529 | $27K | |
| 2022 | 583 | $30K | |
| 2023 | 512 | $35K | |
| 2024incomplete | 602 | $43K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 81% | 3,403 | 2,927 | $159K |
| 94060 | 7.0% | 426 | 395 | $14K | |
| 94726 | 4.1% | 262 | 236 | $8K | |
| 94729 | 4.0% | 265 | 238 | $8K | |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 1.9% | 124 | 110 | $4K |
| 94010 | 1.1% | 94 | 89 | $2K | |
| 99441 | <1% | 43 | 35 | $844.35 | |
| 99442 | <1% | 21 | 21 | $438.16 | |
| 1159F | 0% | 459 | 392 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 143 | 135 | $0.00 |
| 1030F | 0% | 354 | 305 | $0.00 | |
| 1022F | 0% | 290 | 238 | $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 officialRIVERA, OSCAR (PRESIDENT)