Managed care
Gumet, INC.
Gumet, INC. was paid $767K by Medicaid between Jan 2018 and Dec 2024, across 157 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 23% of everything it billed.
33Billing provider infoGUMET, INC.
HUMACAO, PR 00791
HUMACAO, PR 00791
33aNPI1780798066assigned 08/17/2006
33bProvider typeExclusive Provider Organization
28Total paid$767K
24GClaims990,597
24DCodes billed157
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Exclusive Provider Organization providers in Puerto Rico
Rank by total paid#4 of 19
Median peer was paid$250K
This provider vs. median3.1×
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 | 128,652 | $31K | |
| 2019 | 140,672 | $50K | |
| 2020 | 70,659 | $20K | |
| 2021 | 114,627 | $206K | |
| 2022 | 131,144 | $116K | |
| 2023 | 156,152 | $122K | |
| 2024incomplete | 248,691 | $222K |
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 | 23% | 134,906 | 103,679 | $177K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 9.9% | 9,960 | 7,473 | $76K |
| 96160 | 9.2% | 2,686 | 2,532 | $71K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 7.1% | 5,962 | 3,769 | $54K |
| 90461 | 6.6% | 8,917 | 2,915 | $51K | |
| 0002A | 6.2% | 1,310 | 1,205 | $48K | |
| 0001A | 5.3% | 1,136 | 1,082 | $41K | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 5.0% | 6,704 | 4,309 | $38K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.1% | 28,490 | 20,648 | $31K |
| 0004A | 4.0% | 815 | 782 | $30K | |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 3.0% | 15,313 | 10,597 | $23K |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 2.6% | 4,911 | 4,292 | $20K |
145 more codes
| 0012A | 1.4% | 322 | $11K | |
| 0072A | 1.2% | 228 | $9K | |
| 0071A | 1.2% | 233 | $9K | |
| 99203 | Doctor's office visit, new patient (routine) | 1.1% | 2,360 | $8K |
| 0003A | <1% | 423 | $7K | |
| 0011A | <1% | 360 | $7K | |
| 97803 | <1% | 1,618 | $7K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 104 | $6K |
| 0064A | <1% | 125 | $4K | |
| 90670 | <1% | 3,105 | $4K | |
| 90656 | <1% | 2,721 | $4K | |
| 99050 | <1% | 3,243 | $4K | |
| 97802 | <1% | 973 | $3K | |
| 0013A | <1% | 202 | $3K | |
| 90633 | <1% | 2,802 | $3K | |
| 90649 | <1% | 2,621 | $2K | |
| 90734 | <1% | 2,030 | $2K | |
| 90648 | <1% | 2,008 | $2K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 127 | $1K |
| 0124A | <1% | 32 | $1K | |
| 92012 | Ophthalmological services: medical examination and evaluation, intermediate, established patient | <1% | 507 | $1K |
| 91307 | <1% | 480 | $920.00 | |
| 0031A | <1% | 22 | $880.00 | |
| 90733 | <1% | 1,720 | $836.00 | |
| 90723 | <1% | 897 | $784.00 | |
| 90680 | <1% | 605 | $718.00 | |
| 90715 | <1% | 1,079 | $595.00 | |
| 90716 | <1% | 1,393 | $591.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 243 | $544.08 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 852 | $473.80 |
| 99441 | <1% | 23,009 | $472.87 | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 1,898 | $464.04 |
| 90707 | <1% | 1,296 | $378.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 13,205 | $307.97 |
| 90657 | <1% | 323 | $284.00 | |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | <1% | 80 | $246.10 |
| 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% | 31,940 | $240.92 |
| 99442 | <1% | 9,857 | $232.14 | |
| 99443 | <1% | 1,102 | $155.14 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 10,768 | $142.14 |
| 93000 | <1% | 181 | $138.96 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 11,783 | $61.44 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 17,646 | $47.38 |
| 90744 | <1% | 168 | $45.00 | |
| 90698 | <1% | 261 | $18.00 | |
| 99401 | <1% | 10,315 | $12.22 | |
| 91306 | <1% | 57 | $0.01 | |
| 2010F | 0% | 39,552 | $0.00 | |
| 1126F | 0% | 18,175 | $0.00 | |
| 3079F | 0% | 12,444 | $0.00 | |
| 3017F | 0% | 4,168 | $0.00 | |
| 1036F | 0% | 11,539 | $0.00 | |
| 1170F | 0% | 34,700 | $0.00 | |
| 1125F | 0% | 13,075 | $0.00 | |
| 3074F | 0% | 40,165 | $0.00 | |
| 3044F | 0% | 4,407 | $0.00 | |
| 2001F | 0% | 28,777 | $0.00 | |
| 3008F | 0% | 73,044 | $0.00 | |
| 1157F | 0% | 13,400 | $0.00 | |
| 2000F | 0% | 27,366 | $0.00 | |
| 1101F | 0% | 5,805 | $0.00 | |
| 3048F | 0% | 6,345 | $0.00 | |
| 3061F | 0% | 2,443 | $0.00 | |
| 3080F | 0% | 2,396 | $0.00 | |
| 3011F | 0% | 3,982 | $0.00 | |
| 99606 | 0% | 3,791 | $0.00 | |
| 1022F | 0% | 599 | $0.00 | |
| 4010F | 0% | 3,048 | $0.00 | |
| 3075F | 0% | 6,140 | $0.00 | |
| 1034F | 0% | 545 | $0.00 | |
| 1031F | 0% | 262 | $0.00 | |
| 3049F | 0% | 2,207 | $0.00 | |
| 1000F | 0% | 772 | $0.00 | |
| 1030F | 0% | 1,165 | $0.00 | |
| 3037F | 0% | 147 | $0.00 | |
| 3014F | 0% | 2,097 | $0.00 | |
| 3754F | 0% | 32 | $0.00 | |
| 96127 | 0% | 557 | $0.00 | |
| G0328 | Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous | 0% | 207 | $0.00 |
| 1123F | 0% | 246 | $0.00 | |
| 1220F | 0% | 637 | $0.00 | |
| 90696 | 0% | 262 | $0.00 | |
| 1005F | 0% | 182 | $0.00 | |
| 4037F | 0% | 364 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 104 | $0.00 |
| 3351F | 0% | 24 | $0.00 | |
| 3072F | 0% | 579 | $0.00 | |
| 99403 | 0% | 217 | $0.00 | |
| 98967 | 0% | 15 | $0.00 | |
| 0509F | 0% | 71 | $0.00 | |
| 92551 | 0% | 92 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 47 | $0.00 |
| 3060F | 0% | 44 | $0.00 | |
| 99366 | 0% | 107 | $0.00 | |
| G0103 | Prostate cancer screening; prostate specific antigen test (psa) | 0% | 104 | $0.00 |
| 91301 | 0% | 46 | $0.00 | |
| 92250 | 0% | 14 | $0.00 | |
| 92002 | 0% | 12 | $0.00 | |
| 97035 | 0% | 60 | $0.00 | |
| 0513F | 0% | 30 | $0.00 | |
| 0518F | 0% | 3,641 | $0.00 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 1,061 | $0.00 |
| 1159F | 0% | 67,127 | $0.00 | |
| 1160F | 0% | 63,264 | $0.00 | |
| 3077F | 0% | 3,840 | $0.00 | |
| 1158F | 0% | 11,011 | $0.00 | |
| 4035F | 0% | 2,959 | $0.00 | |
| 3078F | 0% | 34,262 | $0.00 | |
| 99497 | 0% | 118 | $0.00 | |
| 0521F | 0% | 17,068 | $0.00 | |
| 2014F | 0% | 7,187 | $0.00 | |
| 99173 | 0% | 521 | $0.00 | |
| 3725F | 0% | 3,906 | $0.00 | |
| 3045F | 0% | 198 | $0.00 | |
| 99408 | 0% | 579 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 337 | $0.00 |
| 99446 | 0% | 795 | $0.00 | |
| 3028F | 0% | 109 | $0.00 | |
| 1003F | 0% | 1,595 | $0.00 | |
| 3050F | 0% | 1,316 | $0.00 | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 915 | $0.00 |
| 4551F | 0% | 1,618 | $0.00 | |
| 98960 | 0% | 124 | $0.00 | |
| 3015F | 0% | 3,894 | $0.00 | |
| 1119F | 0% | 236 | $0.00 | |
| 3016F | 0% | 129 | $0.00 | |
| 2027F | 0% | 12 | $0.00 | |
| 1090F | 0% | 391 | $0.00 | |
| 99242 | 0% | 1,209 | $0.00 | |
| 2028F | 0% | 190 | $0.00 | |
| 1033F | 0% | 830 | $0.00 | |
| 99421 | 0% | 2,882 | $0.00 | |
| 3046F | 0% | 253 | $0.00 | |
| 90700 | 0% | 160 | $0.00 | |
| 99490 | Ccm add 20min | 0% | 370 | $0.00 |
| 91300 | 0% | 966 | $0.00 | |
| 98968 | 0% | 103 | $0.00 | |
| 91312 | 0% | 32 | $0.00 | |
| 99201 | 0% | 33 | $0.00 | |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | 0% | 108 | $0.00 |
| 2022F | 0% | 39 | $0.00 | |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, 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 | 0% | 129 | $0.00 |
| 3095F | 0% | 12 | $0.00 | |
| 99382 | 0% | 12 | $0.00 | |
| 4013F | 0% | 13 | $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 officialFRANCESCHI, MARICARMEN (ADMINISTRATOR)
| Provider | Location | Paid |
|---|---|---|
| Gumet INC | Humacao, PR | $7K |
| Agumet INC. | Humacao, PR | $0.00 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.