Carlos R Ponce MD PA

Carlos R Ponce MD PA was paid $8K by Medicaid between Jan 2018 and Jun 2020, across 5 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 64% of everything it billed.

33Billing provider infoCARLOS R PONCE MD PA
BROWNSVILLE, TX 78526

33aNPI1780850693assigned 05/01/2008

33bProvider typeGastroenterology Physician

28Total paid$8K

24GClaims900

24DCodes billed5

24AFirst – last monthJan 2018 – Jun 2020

Compared with peers

Next to other Gastroenterology Physician providers in Texas

Rank by total paid#45 of 91

Median peer was paid$8K

This provider vs. median1.0×

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	374	$3K
2019	413	$2K
2020	113	$3K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
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	64%	585	573	$5K
43239	Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple	33%	274	271	$3K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	2.4%	13	13	$181.03
1036F		0%	13	13	$0.00
99222	Initial hospital care, per day, moderate complexity	0%	15	15	$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 officialPONCE, CARLOS (PRESIDENT)