Physician
Southern Health Care Group, INC.
Southern Health Care Group, INC. was paid $622K by Medicaid between Jan 2018 and Dec 2024, across 119 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 34% of everything it billed.
33Billing provider infoSOUTHERN HEALTH CARE GROUP, INC.
GUAYAMA, PR 00784
GUAYAMA, PR 00784
33aNPI1780770917assigned 10/05/2006
33bProvider typePediatrics Physician
28Total paid$622K
24GClaims347,469
24DCodes billed119
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Pediatrics Physician providers in Puerto Rico
Rank by total paid#14 of 194
Median peer was paid$7K
This provider vs. median92×
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 | 31,550 | $29K | |
| 2019 | 31,505 | $30K | |
| 2020 | 22,738 | $71K | |
| 2021 | 38,858 | $181K | |
| 2022 | 38,636 | $102K | |
| 2023 | 95,617 | $167K | |
| 2024incomplete | 88,565 | $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 | 34% | 91,952 | 76,272 | $209K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 8.4% | 1,816 | 1,050 | $52K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | 5.5% | 485 | 392 | $34K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 5.0% | 1,439 | 1,188 | $31K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 5.0% | 9,908 | 8,823 | $31K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 4.4% | 458 | 268 | $28K |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 3.6% | 5,570 | 4,058 | $22K |
| 90461 | 3.5% | 3,393 | 2,566 | $22K | |
| 99441 | 3.3% | 3,658 | 3,121 | $21K | |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 3.2% | 1,486 | 1,272 | $20K |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 2.9% | 767 | 500 | $18K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.5% | 2,292 | 1,654 | $16K |
107 more codes
| 99443 | 2.3% | 385 | $14K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.0% | 2,721 | $12K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.8% | 3,610 | $11K |
| 99442 | 1.7% | 1,450 | $11K | |
| 99214 | Doctor's office visit, returning patient (more involved) | 1.7% | 1,840 | $10K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.1% | 15,192 | $7K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 1,440 | $6K |
| 0012A | <1% | 124 | $5K | |
| 0011A | <1% | 132 | $5K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 2,609 | $4K |
| 90670 | <1% | 1,064 | $4K | |
| 90658 | <1% | 3,382 | $3K | |
| 99245 | <1% | 473 | $3K | |
| 0071A | <1% | 67 | $3K | |
| 0124A | <1% | 64 | $3K | |
| 0072A | <1% | 59 | $2K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 278 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 1,363 | $2K |
| 0031A | <1% | 44 | $2K | |
| 0073A | <1% | 43 | $2K | |
| 96127 | <1% | 16,958 | $1K | |
| 96160 | <1% | 8,564 | $1K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 578 | $1K |
| 0013A | <1% | 27 | $1K | |
| 99383 | <1% | 121 | $739.64 | |
| 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% | 2,867 | $639.38 |
| 0054A | <1% | 13 | $520.00 | |
| 96161 | <1% | 6,540 | $421.90 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 15 | $340.00 |
| 99368 | <1% | 796 | $304.01 | |
| 90715 | <1% | 471 | $273.99 | |
| 90698 | <1% | 426 | $118.64 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 244 | $75.93 |
| 90744 | <1% | 55 | $51.68 | |
| 90700 | <1% | 418 | $48.00 | |
| 99381 | <1% | 18 | $33.62 | |
| 99384 | <1% | 125 | $30.00 | |
| 96151 | <1% | 165 | $29.08 | |
| 96150 | <1% | 347 | $15.29 | |
| 90649 | <1% | 1,098 | $8.05 | |
| 90620 | <1% | 417 | $8.02 | |
| 90734 | <1% | 799 | $4.03 | |
| 90633 | <1% | 122 | $4.00 | |
| 3075F | <1% | 4,704 | $0.02 | |
| 3079F | <1% | 6,429 | $0.02 | |
| 3008F | <1% | 23,336 | $0.01 | |
| 90716 | <1% | 136 | $0.01 | |
| 90396 | <1% | 163 | $0.01 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 12,467 | $0.00 |
| 1036F | 0% | 3,207 | $0.00 | |
| 2000F | 0% | 1,246 | $0.00 | |
| 1170F | 0% | 4,199 | $0.00 | |
| 3017F | 0% | 1,051 | $0.00 | |
| 3074F | 0% | 16,587 | $0.00 | |
| 4010F | 0% | 1,825 | $0.00 | |
| 3049F | 0% | 551 | $0.00 | |
| 99241 | 0% | 157 | $0.00 | |
| 90480 | 0% | 21 | $0.00 | |
| 1157F | 0% | 2,141 | $0.00 | |
| 1126F | 0% | 6,288 | $0.00 | |
| 1125F | 0% | 2,370 | $0.00 | |
| 3044F | 0% | 1,549 | $0.00 | |
| 3061F | 0% | 1,335 | $0.00 | |
| 3080F | 0% | 1,177 | $0.00 | |
| 3048F | 0% | 1,582 | $0.00 | |
| 2010F | 0% | 27 | $0.00 | |
| 3066F | 0% | 730 | $0.00 | |
| 1111F | 0% | 902 | $0.00 | |
| 97804 | 0% | 672 | $0.00 | |
| 3014F | 0% | 261 | $0.00 | |
| 1030F | 0% | 104 | $0.00 | |
| 90680 | 0% | 19 | $0.00 | |
| 2001F | 0% | 1,029 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 29 | $0.00 |
| 3060F | 0% | 41 | $0.00 | |
| 3279F | 0% | 94 | $0.00 | |
| 86580 | 0% | 47 | $0.00 | |
| 1101F | 0% | 168 | $0.00 | |
| 3072F | 0% | 35 | $0.00 | |
| 90696 | 0% | 31 | $0.00 | |
| 99050 | 0% | 15 | $0.00 | |
| 3077F | 0% | 4,353 | $0.00 | |
| 3050F | 0% | 181 | $0.00 | |
| 1159F | 0% | 8,172 | $0.00 | |
| 0518F | 0% | 1,116 | $0.00 | |
| 3078F | 0% | 17,844 | $0.00 | |
| 0521F | 0% | 2,243 | $0.00 | |
| 4035F | 0% | 346 | $0.00 | |
| 1158F | 0% | 1,804 | $0.00 | |
| 90648 | 0% | 28 | $0.00 | |
| 1160F | 0% | 7,529 | $0.00 | |
| 3095F | 0% | 376 | $0.00 | |
| 3062F | 0% | 12 | $0.00 | |
| 3725F | 0% | 2,653 | $0.00 | |
| 3051F | 0% | 53 | $0.00 | |
| 97803 | 0% | 421 | $0.00 | |
| 1090F | 0% | 452 | $0.00 | |
| 90630 | 0% | 1,593 | $0.00 | |
| 99408 | 0% | 406 | $0.00 | |
| 96152 | 0% | 45 | $0.00 | |
| 90707 | 0% | 91 | $0.00 | |
| 1033F | 0% | 161 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 26 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 30 | $0.00 |
| 91320 | 0% | 20 | $0.00 | |
| 2022F | 0% | 12 | $0.00 | |
| 99367 | 0% | 29 | $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 officialLOPEZ, SERGIO (DIRECTOR MEDICO)
| Provider | Location | Paid |
|---|---|---|
| Sergio E Lopez, DDS, Pediatric Dentistry, PLLC | Edinburg, TX | $3.45M |
| Sergio M. Lopez, D.D.S.,P. L.L.C. | Tampa, FL | $10K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.