Physician
Montalvo Ayala, Rafael
Montalvo Ayala, Rafael was paid $173K by Medicaid between Jan 2018 and Aug 2022, across 17 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 62% of everything it billed.
33Billing provider infoMONTALVO AYALA, RAFAEL
NORTH PROVIDENCE, RI 02904
NORTH PROVIDENCE, RI 02904
33aNPI1891993507assigned 07/03/2007
33bProvider typePediatrics Physician
28Total paid$173K
24GClaims5,305
24DCodes billed17
24AFirst – last monthJan 2018 – Aug 2022
Compared with peers
Next to other Pediatrics Physician providers in Rhode Island
Rank by total paid#107 of 265
Median peer was paid$133K
This provider vs. median1.3×
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.
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 | 1,298 | $45K | |
| 2019 | 1,421 | $43K | |
| 2020 | 972 | $26K | |
| 2021 | 1,078 | $38K | |
| 2022 | 536 | $21K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 62% | 1,832 | 1,660 | $107K |
| 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 | 11% | 272 | 215 | $19K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 7.9% | 1,098 | 1,049 | $14K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 3.2% | 66 | 54 | $6K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 3.1% | 540 | 516 | $5K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 2.9% | 267 | 238 | $5K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 2.6% | 131 | 122 | $5K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 2.3% | 43 | 41 | $4K |
| U0002 | 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc | 1.7% | 112 | 95 | $3K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.1% | 24 | 24 | $2K |
| 99050 | 1.0% | 61 | 57 | $2K | |
| 0002A | <1% | 12 | 12 | $499.56 |
5 more codes
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.