Physician
Rafael Rafols MD PA
Rafael Rafols MD PA was paid $221K by Medicaid between Jan 2018 and Nov 2024, across 12 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 25% of everything it billed.
33Billing provider infoRAFAEL RAFOLS MD PA
MISSION, TX 78572
MISSION, TX 78572
33aNPI1891071106assigned 10/31/2011
33bProvider typeFamily Medicine Physician
28Total paid$221K
24GClaims22,160
24DCodes billed12
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Family Medicine Physician providers in Texas
Rank by total paid#288 of 1,204
Median peer was paid$31K
This provider vs. median7.2×
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 | 3,110 | $8K | |
| 2019 | 2,831 | $9K | |
| 2020 | 3,021 | $12K | |
| 2021 | 4,129 | $44K | |
| 2022 | 3,719 | $61K | |
| 2023 | 2,288 | $40K | |
| 2024incomplete | 3,062 | $47K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 25% | 3,906 | 1,416 | $55K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 23% | 10,977 | 4,358 | $51K |
| 99222 | Initial hospital care, per day, moderate complexity | 20% | 1,781 | 1,695 | $43K |
| 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 | 15% | 2,264 | 1,907 | $34K |
| 99233 | Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m | 6.4% | 843 | 274 | $14K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | 5.3% | 809 | 673 | $12K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 3.4% | 1,104 | 951 | $8K |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | 1.1% | 116 | 56 | $2K |
| 99305 | <1% | 305 | 303 | $2K | |
| 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 | <1% | 12 | 12 | $374.90 |
| 97597 | <1% | 29 | 28 | $109.08 | |
| 99442 | 0% | 14 | 14 | $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 officialRAFOLS, RAFAEL (SOLE MEMBER)