San Jorge Pediatric Orthopaedic Institute

San Jorge Pediatric Orthopaedic Institute was paid $142K by Medicaid between Jan 2018 and Feb 2019, across 5 billing codes. Its largest line is 99203, doctor's office visit, new patient (routine) — 53% of everything it billed.

33Billing provider infoSAN JORGE PEDIATRIC ORTHOPAEDIC INSTITUTE
SAN JUAN, PR 00912

33aNPI1700158391assigned 01/30/2012

33bProvider typeChildren's Hospital

28Total paid$142K

24GClaims3,159

24DCodes billed5

24AFirst – last monthJan 2018 – Feb 2019

Compared with peers

Next to other Children's Hospital providers in Puerto Rico

Rank by total paid#2 of 5

Median peer was paid$119K

This provider vs. median1.2×

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	2,978	$134K
2019	181	$8K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	53%	1,335	1,291	$75K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	45%	1,733	1,535	$64K
25600		2.4%	17	16	$3K
G0380	Level 1 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)	0%	37	35	$0.00
G0381	Level 2 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment)	0%	37	37	$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 officialNIEVES, AMAIRA (CREDIT MANAGER)

Parent organizationSAN JORGE CHILDREN'S HOSPITAL, INC