Clinic
Prymed Medical Care, INC
Prymed Medical Care, INC was paid $2.12M by Medicaid between Jan 2018 and Dec 2024, across 178 billing codes. Its largest line is 96160, — 21% of everything it billed.
33Billing provider infoPRYMED MEDICAL CARE, INC
CIALES, PR 00638
CIALES, PR 00638
33aNPI1881661866assigned 03/08/2006
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$2.12M
24GClaims294,290
24DCodes billed178
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Puerto Rico
Rank by total paid#3 of 22
Median peer was paid$463K
This provider vs. median4.6×
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 | 24,617 | $335K | |
| 2019 | 25,041 | $186K | |
| 2020 | 30,894 | $151K | |
| 2021 | 59,492 | $482K | |
| 2022 | 55,828 | $384K | |
| 2023 | 57,632 | $245K | |
| 2024incomplete | 40,786 | $335K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96160 | 21% | 17,396 | 17,179 | $447K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 17% | 63,977 | 56,034 | $360K |
| D1110 | Prophylaxis - adult | 9.1% | 6,852 | 5,659 | $193K |
| D1999 | 4.8% | 6,849 | 5,996 | $102K | |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 4.3% | 2,538 | 2,116 | $92K |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | 4.2% | 6,421 | 5,315 | $90K |
| 0002A | 3.9% | 2,223 | 2,052 | $83K | |
| 0001A | 3.6% | 2,222 | 2,070 | $77K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 3.3% | 8,213 | 7,494 | $69K |
| D0330 | Panoramic radiographic image | 3.2% | 2,234 | 1,783 | $67K |
| D0272 | Bitewings - two radiographic images | 3.1% | 4,676 | 3,827 | $66K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.1% | 3,840 | 3,533 | $45K |
166 more codes
| D1208 | Topical application of fluoride, excluding varnish | 1.9% | 2,907 | $41K |
| 0004A | 1.6% | 1,429 | $34K | |
| D0150 | Comprehensive oral evaluation - new or established patient | 1.6% | 1,745 | $34K |
| D1120 | Dental cleaning, child | 1.3% | 1,420 | $27K |
| 0011A | 1.2% | 683 | $25K | |
| 0012A | 1.1% | 607 | $23K | |
| 97802 | 1.0% | 1,139 | $22K | |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 3,357 | $17K |
| D2150 | Silver amalgam - two surfaces, primary or permanent | <1% | 455 | $16K |
| 0072A | <1% | 500 | $15K | |
| 99050 | <1% | 503 | $14K | |
| 0064A | <1% | 554 | $14K | |
| 0071A | <1% | 664 | $10K | |
| 97803 | <1% | 588 | $10K | |
| 99283 | Emergency room visit (moderate) | <1% | 315 | $10K |
| D2140 | <1% | 325 | $8K | |
| 92015 | Determination of refractive state | <1% | 752 | $7K |
| 90832 | Psychotherapy session, about 30 minutes | <1% | 3,192 | $7K |
| D0140 | Limited oral evaluation - problem focused | <1% | 327 | $6K |
| 90732 | <1% | 535 | $5K | |
| 90658 | <1% | 1,445 | $5K | |
| 90656 | <1% | 539 | $5K | |
| D0230 | Intraoral - periapical each additional radiographic image | <1% | 1,426 | $5K |
| D1351 | Sealant - per tooth | <1% | 353 | $5K |
| D0220 | Intraoral - periapical first radiographic image | <1% | 623 | $4K |
| 0003A | <1% | 94 | $4K | |
| 0124A | <1% | 256 | $3K | |
| 99441 | <1% | 1,437 | $3K | |
| 92002 | <1% | 96 | $3K | |
| 90670 | <1% | 1,626 | $3K | |
| 90474 | <1% | 292 | $2K | |
| 0054A | <1% | 241 | $2K | |
| 76700 | Ultrasound, abdominal, real time with image documentation; complete | <1% | 42 | $2K |
| D2160 | <1% | 38 | $2K | |
| 90649 | <1% | 609 | $2K | |
| 90715 | <1% | 1,136 | $2K | |
| 76830 | Ultrasound, transvaginal | <1% | 41 | $2K |
| 90734 | <1% | 1,321 | $2K | |
| 90648 | <1% | 769 | $2K | |
| G0101 | Cervical or vaginal cancer screening; pelvic and clinical breast examination | <1% | 987 | $2K |
| 90716 | <1% | 1,026 | $1K | |
| 90686 | <1% | 3,076 | $1K | |
| D3120 | <1% | 86 | $1K | |
| 76536 | <1% | 34 | $1K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 897 | $1K |
| 90707 | <1% | 964 | $1K | |
| 90680 | <1% | 783 | $1K | |
| 99442 | <1% | 1,483 | $1K | |
| 90633 | <1% | 762 | $1K | |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 175 | $875.67 |
| 90698 | <1% | 284 | $748.62 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 595 | $739.63 |
| 99347 | <1% | 42 | $601.00 | |
| 90621 | <1% | 220 | $576.36 | |
| 90671 | <1% | 191 | $537.76 | |
| 90723 | <1% | 304 | $536.69 | |
| 93000 | <1% | 1,668 | $533.54 | |
| 90657 | <1% | 118 | $472.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 1,442 | $416.90 |
| 71046 | Radiologic examination, chest; 2 views | <1% | 41 | $405.33 |
| 97804 | <1% | 18 | $219.06 | |
| V2020 | Frames, purchases | <1% | 188 | $200.00 |
| 0134A | <1% | 64 | $200.00 | |
| D1206 | Topical application of fluoride varnish | <1% | 12 | $178.92 |
| 90696 | <1% | 175 | $157.02 | |
| G0008 | Administration of influenza virus vaccine | <1% | 552 | $140.94 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 1,603 | $123.69 |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 252 | $121.81 |
| 0074A | <1% | 80 | $120.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 57 | $97.41 |
| 90651 | <1% | 1,116 | $94.52 | |
| 90700 | <1% | 30 | $52.15 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 455 | $45.90 |
| 87426 | Infectious agent antigen detection, SARS-CoV-2 (COVID-19) | <1% | 23 | $45.23 |
| 90620 | <1% | 77 | $40.41 | |
| 90473 | <1% | 18 | $40.00 | |
| 1158F | <1% | 26 | $40.00 | |
| 0081A | <1% | 14 | $40.00 | |
| 96127 | <1% | 1,064 | $28.40 | |
| 99368 | <1% | 166 | $24.37 | |
| 3077F | <1% | 3,459 | $21.00 | |
| 86738 | <1% | 21 | $18.76 | |
| 90677 | <1% | 149 | $0.22 | |
| 90632 | <1% | 12 | $0.12 | |
| 90623 | <1% | 14 | $0.02 | |
| 1160F | 0% | 15,088 | $0.00 | |
| 4035F | 0% | 10,476 | $0.00 | |
| 1159F | 0% | 16,161 | $0.00 | |
| 85610 | 0% | 14 | $0.00 | |
| G0144 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision | 0% | 90 | $0.00 |
| 91312 | 0% | 256 | $0.00 | |
| 3078F | 0% | 9,651 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 1,179 | $0.00 |
| 90750 | 0% | 39 | $0.00 | |
| 76770 | 0% | 13 | $0.00 | |
| 82947 | 0% | 27 | $0.00 | |
| 80074 | 0% | 12 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 27 | $0.00 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 25 | $0.00 |
| 99173 | 0% | 159 | $0.00 | |
| 91313 | 0% | 63 | $0.00 | |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 442 | $0.00 |
| 90611 | 0% | 29 | $0.00 | |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 89 | $0.00 |
| 91300 | 0% | 699 | $0.00 | |
| 3050F | 0% | 12 | $0.00 | |
| 3051F | 0% | 13 | $0.00 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 0% | 20 | $0.00 |
| 80061 | Lipid panel | 0% | 178 | $0.00 |
| 92014 | Ophthalmological services: medical examination and evaluation, comprehensive, established patient | 0% | 96 | $0.00 |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | 0% | 24 | $0.00 |
| 3725F | 0% | 22 | $0.00 | |
| G8482 | Influenza immunization administered or previously received | 0% | 15 | $0.00 |
| 91320 | 0% | 15 | $0.00 | |
| 91308 | 0% | 26 | $0.00 | |
| 82274 | 0% | 29 | $0.00 | |
| 84439 | 0% | 55 | $0.00 | |
| 3017F | 0% | 699 | $0.00 | |
| 3074F | 0% | 7,889 | $0.00 | |
| 1125F | 0% | 4,160 | $0.00 | |
| 3079F | 0% | 2,981 | $0.00 | |
| 1126F | 0% | 11,112 | $0.00 | |
| 3008F | 0% | 14,533 | $0.00 | |
| 3048F | 0% | 1,488 | $0.00 | |
| 3075F | 0% | 2,376 | $0.00 | |
| 3044F | 0% | 935 | $0.00 | |
| 3061F | 0% | 424 | $0.00 | |
| 3080F | 0% | 998 | $0.00 | |
| 81001 | 0% | 168 | $0.00 | |
| 3049F | 0% | 827 | $0.00 | |
| 91305 | 0% | 253 | $0.00 | |
| 82607 | 0% | 18 | $0.00 | |
| 1030F | 0% | 500 | $0.00 | |
| V2784 | Lens, polycarbonate or equal, any index, per lens | 0% | 130 | $0.00 |
| 91307 | 0% | 545 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 655 | $0.00 |
| 92004 | Ophthalmological services: medical examination and evaluation, comprehensive, new patient | 0% | 245 | $0.00 |
| 1034F | 0% | 175 | $0.00 | |
| 80048 | Basic metabolic panel (calcium, ionized) | 0% | 47 | $0.00 |
| 1170F | 0% | 231 | $0.00 | |
| 3014F | 0% | 28 | $0.00 | |
| 82043 | 0% | 27 | $0.00 | |
| 90480 | 0% | 28 | $0.00 | |
| 90619 | 0% | 52 | $0.00 | |
| G0009 | Administration of pneumococcal vaccine | 0% | 41 | $0.00 |
| 99384 | 0% | 15 | $0.00 | |
| 86592 | 0% | 40 | $0.00 | |
| 1111F | 0% | 18 | $0.00 | |
| G2061 | Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes | 0% | 17 | $0.00 |
| 84436 | 0% | 15 | $0.00 | |
| 80053 | Comprehensive metabolic panel | 0% | 196 | $0.00 |
| 84443 | Thyroid stimulating hormone (TSH) | 0% | 133 | $0.00 |
| 87590 | 0% | 24 | $0.00 | |
| 1036F | 0% | 82 | $0.00 | |
| 91306 | 0% | 208 | $0.00 | |
| 86580 | 0% | 17 | $0.00 | |
| 83036 | Hemoglobin; glycosylated (A1C) | 0% | 75 | $0.00 |
| 3060F | 0% | 12 | $0.00 | |
| 99214 | Doctor's office visit, returning patient (more involved) | 0% | 16 | $0.00 |
| 99406 | 0% | 15 | $0.00 | |
| 90697 | 0% | 17 | $0.00 | |
| 86803 | 0% | 24 | $0.00 | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | 0% | 33 | $0.00 |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | 0% | 37 | $0.00 |
| 87088 | 0% | 29 | $0.00 | |
| 85730 | 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 officialRIVERA, GLADYS (EXECUTIVE DIRECTOR)
| Provider | Location | Paid |
|---|---|---|
| Prymed Medical Care, INC | Ciales, PR | $913K |
| Prymed Medical Care, INC | Vega Baja, PR | $771K |
| Rayosx Prymed Medical Care, INC. | Ciales, PR | $380K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.