Physician
Berrios-Marcano, Rafael
Berrios-Marcano, Rafael was paid $95K by Medicaid between Jan 2018 and Oct 2024, across 6 billing codes. Its largest line is 99212, Office or other outpatient visit for the evaluation and management of an established patient, straightforward — 45% of everything it billed.
33Billing provider infoBERRIOS-MARCANO, RAFAEL
BAYAMON, PR 00961
BAYAMON, PR 00961
33aNPI1861542243assigned 01/10/2007
33bProvider typeObstetrics & Gynecology Physician
28Total paid$95K
24GClaims5,742
24DCodes billed6
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Obstetrics & Gynecology Physician providers in Puerto Rico
Rank by total paid#67 of 185
Median peer was paid$53K
This provider vs. median1.8×
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 | 1,136 | $14K | |
| 2019 | 804 | $9K | |
| 2020 | 657 | $7K | |
| 2021 | 914 | $12K | |
| 2022 | 1,257 | $24K | |
| 2023 | 849 | $21K | |
| 2024incomplete | 125 | $8K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 45% | 3,440 | 2,411 | $42K |
| 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 | 40% | 1,398 | 1,031 | $38K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 11% | 354 | 267 | $10K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | 4.1% | 483 | 451 | $4K |
| 59425 | 1.3% | 45 | 40 | $1K | |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | 0% | 22 | 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.