Physician
Nieves-Matias, Benny
Nieves-Matias, Benny was paid $108K by Medicaid between Apr 2018 and Oct 2024, across 21 billing codes. Its largest line is 99285, emergency room visit (most serious) — 53% of everything it billed.
33Billing provider infoNIEVES-MATIAS, BENNY
GUAYNABO, PR 00969
GUAYNABO, PR 00969
33aNPI1669874681assigned 09/22/2014
33bProvider typeGeneral Practice Physician
28Total paid$108K
24GClaims4,363
24DCodes billed21
24AFirst – last monthApr 2018 – Oct 2024
Compared with peers
Next to other General Practice Physician providers in Puerto Rico
Rank by total paid#172 of 1,195
Median peer was paid$2K
This provider vs. median53×
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 | 37 | $505.00 | |
| 2019 | 153 | $2K | |
| 2020 | 91 | $1K | |
| 2023 | 3,031 | $48K | |
| 2024incomplete | 1,051 | $57K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 53% | 449 | 332 | $58K |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 25% | 309 | 239 | $27K |
| 99235 | 7.1% | 99 | 86 | $8K | |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 7.1% | 182 | 177 | $8K |
| 99281 | Emergency department visit for the evaluation and management, self-limited or minor | 2.3% | 228 | 223 | $2K |
| 96160 | 1.7% | 214 | 184 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 1.5% | 772 | 696 | $2K |
| 99234 | 1.3% | 48 | 44 | $1K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 468 | 437 | $222.96 |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 30 | 28 | $208.68 |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 142 | 122 | $69.26 |
| 1159F | 0% | 303 | 286 | $0.00 |
9 more codes
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.