Lopez, Berto

Lopez, Berto was paid $150K by Medicaid between Dec 2018 and Feb 2021, across 10 billing codes. Its largest line is H1000, Prenatal care, at-risk assessment — 50% of everything it billed.

33Billing provider infoLOPEZ, BERTO
WEST PALM BEACH, FL 33401

33aNPI1831176544assigned 12/23/2005

33bProvider typeObstetrics & Gynecology Physician

28Total paid$150K

24GClaims1,999

24DCodes billed10

24AFirst – last monthDec 2018 – Feb 2021

Compared with peers

Next to other Obstetrics & Gynecology Physician providers in Florida

Rank by total paid#126 of 352

Median peer was paid$67K

This provider vs. median2.3×

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 (01/19/2023).

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	16	$836.16
2019	1,108	$81K
2020	726	$57K
2021	149	$11K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H1000	Prenatal care, at-risk assessment	50%	1,185	676	$75K
95165	Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials	17%	112	22	$26K
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	17%	319	256	$25K
76819	Fetal biophysical profile; without non-stress testing	6.2%	171	93	$9K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	2.7%	38	24	$4K
76815	Ultrasound, pregnant uterus, real time with image documentation, limited	2.3%	71	68	$3K
95004	Percutaneous tests with allergenic extracts, immediate type reaction	1.6%	16	15	$2K
99215	Doctor's office visit, returning patient (complex)Prolong outpt/office vis	1.2%	27	25	$2K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1.2%	40	29	$2K
76805	Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation	<1%	20	19	$888.49

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.