Physician
Physician Hmo INC.
Physician Hmo INC. was paid $410K by Medicaid between Jan 2018 and May 2024, across 49 billing codes. Its largest line is 99050, — 51% of everything it billed.
33Billing provider infoPHYSICIAN HMO INC.
SAN JUAN, PR 00918
SAN JUAN, PR 00918
33aNPI1689946956assigned 02/02/2012
33bProvider typeGeneral Practice Physician
28Total paid$410K
24GClaims419,550
24DCodes billed49
24AFirst – last monthJan 2018 – May 2024
Compared with peers
Next to other General Practice Physician providers in Puerto Rico
Rank by total paid#59 of 1,195
Median peer was paid$2K
This provider vs. median200×
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 | 100,104 | $104K | |
| 2019 | 71,425 | $57K | |
| 2020 | 48,423 | $83K | |
| 2021 | 66,084 | $77K | |
| 2022 | 67,216 | $62K | |
| 2023 | 59,328 | $26K | |
| 2024incomplete | 6,970 | $520.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99050 | 51% | 5,508 | 4,916 | $209K | |
| 96160 | 33% | 5,417 | 5,230 | $133K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 14% | 51,153 | 41,260 | $56K |
| 99441 | <1% | 680 | 646 | $3K | |
| 99442 | <1% | 621 | 574 | $2K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 3,303 | 2,611 | $2K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 1,902 | 1,788 | $1K |
| 99422 | <1% | 198 | 198 | $1K | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 646 | 519 | $923.91 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 5,128 | 4,181 | $876.53 |
| 96127 | <1% | 32,378 | 26,632 | $538.47 | |
| 99201 | <1% | 226 | 224 | $475.00 |
37 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 1,893 | $331.66 |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 14 | $52.00 |
| 99243 | <1% | 452 | $50.00 | |
| 99443 | <1% | 30 | $40.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 451 | $18.48 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 306 | $2.00 |
| 3075F | 0% | 7,691 | $0.00 | |
| 1036F | 0% | 1,470 | $0.00 | |
| 1157F | 0% | 50,339 | $0.00 | |
| 3074F | 0% | 32,916 | $0.00 | |
| 1031F | 0% | 18,271 | $0.00 | |
| 1035F | 0% | 7,039 | $0.00 | |
| 1125F | 0% | 8,290 | $0.00 | |
| 3008F | 0% | 45,059 | $0.00 | |
| 3049F | 0% | 54 | $0.00 | |
| 1126F | 0% | 34,818 | $0.00 | |
| 3079F | 0% | 10,326 | $0.00 | |
| 1170F | 0% | 5,896 | $0.00 | |
| 3080F | 0% | 2,487 | $0.00 | |
| 3048F | 0% | 182 | $0.00 | |
| 1111F | 0% | 590 | $0.00 | |
| 3017F | 0% | 234 | $0.00 | |
| 4000F | 0% | 963 | $0.00 | |
| 3044F | 0% | 68 | $0.00 | |
| 99383 | 0% | 14 | $0.00 | |
| 3078F | 0% | 32,164 | $0.00 | |
| 1158F | 0% | 2,323 | $0.00 | |
| 1160F | 0% | 2,347 | $0.00 | |
| 1159F | 0% | 2,667 | $0.00 | |
| 3077F | 0% | 4,611 | $0.00 | |
| 3725F | 0% | 35,724 | $0.00 | |
| 1090F | 0% | 655 | $0.00 | |
| 0521F | 0% | 380 | $0.00 | |
| 1032F | 0% | 335 | $0.00 | |
| 3050F | 0% | 397 | $0.00 | |
| 4004F | 0% | 822 | $0.00 | |
| 3015F | 0% | 112 | $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 officialVILLALOBOS, RAUL (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Physician Hmo INC. | Rio Piedras, PR | $58.50 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.