Clinic
Gastro Med De Puerto Rico PSC
Gastro Med De Puerto Rico PSC was paid $508K by Medicaid between Jan 2018 and Oct 2024, across 11 billing codes. Its largest line is 99070, — 33% of everything it billed.
33Billing provider infoGASTRO MED DE PUERTO RICO PSC
CAGUAS, PR 00725
CAGUAS, PR 00725
33aNPI1912373432assigned 08/19/2015
33bProvider typeMedical Specialty Clinic/Center
28Total paid$508K
24GClaims4,092
24DCodes billed11
24AFirst – last monthJan 2018 – Oct 2024
Compared with peers
Next to other Medical Specialty Clinic/Center providers in Puerto Rico
Rank by total paid#8 of 54
Median peer was paid$61K
This provider vs. median8.3×
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 | 2,118 | $282K | |
| 2019 | 1,186 | $138K | |
| 2020 | 632 | $71K | |
| 2021 | 65 | $8K | |
| 2023 | 19 | $2K | |
| 2024incomplete | 72 | $8K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99070 | 33% | 1,406 | 1,129 | $168K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 27% | 448 | 398 | $136K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 23% | 355 | 331 | $117K |
| 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 | 5.4% | 726 | 647 | $28K |
| 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 | 5.4% | 506 | 483 | $27K |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | 4.5% | 518 | 361 | $23K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 1.0% | 12 | 12 | $5K |
| 83013 | <1% | 26 | 26 | $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% | 28 | 26 | $1K |
| 99442 | <1% | 41 | 36 | $923.32 | |
| 83014 | <1% | 26 | 26 | $237.00 |
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 officialMARTINEZ, GINES (PRESIDENT)