Merced, Pablo

Merced, Pablo was paid $3.17M by Medicaid between Jan 2018 and Jan 2023, across 5 billing codes. Its largest line is T2023, Targeted case management; per month — 53% of everything it billed.

33Billing provider infoMERCED, PABLO
JACKSON, KY 41339

33aNPI1770633182assigned 01/11/2007

33bProvider typeFamily Medicine Physician

28Total paid$3.17M

24GClaims40,426

24DCodes billed5

24AFirst – last monthJan 2018 – Jan 2023

Compared with peers

Next to other Family Medicine Physician providers in Kentucky

Rank by total paid#22 of 352

Median peer was paid$90K

This provider vs. median35×

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.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

OIG exclusionListed on the federal exclusion list (04/14/2023).

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	13,373	$839K
2019	8,984	$505K
2020	7,624	$737K
2021	5,779	$630K
2022	4,444	$429K
2023	222	$26K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
T2023	Targeted case management; per month	53%	4,892	4,705	$1.68M
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	33%	26,253	7,432	$1.05M
90832	Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient	13%	9,059	5,749	$415K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	<1%	195	186	$14K
G2012	Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion	<1%	27	27	$321.15

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.