Policlinica LA Familia Toa Alta, INC.
Policlinica LA Familia Toa Alta, INC. was paid $47K by Medicaid between Jan 2018 and Feb 2023, across 69 billing codes. Its largest line is 99211, Office or other outpatient visit for the evaluation and management of an established patient, minimal severity — 92% of everything it billed.
33Billing provider infoPOLICLINICA LA FAMILIA TOA ALTA, INC.
TOA ALTA, PR 00953
TOA ALTA, PR 00953
33aNPI1932136470assigned 06/28/2006
33bProvider typeSpecialist
28Total paid$47K
24GClaims126,853
24DCodes billed69
24AFirst – last monthJan 2018 – Feb 2023
Compared with peers
Next to other Specialist providers in Puerto Rico
Rank by total paid#130 of 316
Median peer was paid$26K
This provider vs. median1.9×
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 | 34,682 | $1K | |
| 2019 | 23,456 | $2K | |
| 2020 | 20,759 | $16K | |
| 2021 | 17,604 | $15K | |
| 2022 | 26,957 | $12K | |
| 2023 | 3,395 | $360.00 |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 92% | 2,186 | 2,013 | $44K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.9% | 15,582 | 13,137 | $4K |
| 99442 | <1% | 3,324 | 3,107 | $106.98 | |
| 4035F | 0% | 8,125 | 7,149 | $0.00 | |
| 3288F | 0% | 1,304 | 1,125 | $0.00 | |
| 4013F | 0% | 3,280 | 3,014 | $0.00 | |
| 1159F | 0% | 6,928 | 6,216 | $0.00 | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 262 | 231 | $0.00 |
| 1158F | 0% | 4,142 | 3,774 | $0.00 | |
| 3077F | 0% | 1,981 | 1,742 | $0.00 | |
| 3078F | 0% | 4,456 | 3,726 | $0.00 | |
| 3725F | 0% | 2,233 | 2,082 | $0.00 |
57 more codes
| 1160F | 0% | 7,107 | $0.00 | |
| 3028F | 0% | 2,960 | $0.00 | |
| 0521F | 0% | 2,238 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 453 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 50 | $0.00 |
| 99387 | 0% | 15 | $0.00 | |
| 0518F | 0% | 1,223 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 32 | $0.00 |
| 3051F | 0% | 88 | $0.00 | |
| 3050F | 0% | 137 | $0.00 | |
| 99203 | Doctor's office visit, new patient (routine) | 0% | 81 | $0.00 |
| 1100F | 0% | 18 | $0.00 | |
| 1090F | 0% | 26 | $0.00 | |
| 99397 | 0% | 14 | $0.00 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 12 | $0.00 |
| 1030F | 0% | 582 | $0.00 | |
| 1170F | 0% | 9,674 | $0.00 | |
| 4010F | 0% | 5,603 | $0.00 | |
| 4008F | 0% | 870 | $0.00 | |
| 99385 | 0% | 122 | $0.00 | |
| 1125F | 0% | 2,854 | $0.00 | |
| 3017F | 0% | 541 | $0.00 | |
| 3008F | 0% | 10,759 | $0.00 | |
| 1036F | 0% | 6,468 | $0.00 | |
| 3080F | 0% | 658 | $0.00 | |
| 3075F | 0% | 916 | $0.00 | |
| 3074F | 0% | 3,516 | $0.00 | |
| 3754F | 0% | 770 | $0.00 | |
| 3351F | 0% | 881 | $0.00 | |
| 3049F | 0% | 182 | $0.00 | |
| 1126F | 0% | 3,788 | $0.00 | |
| 99443 | 0% | 650 | $0.00 | |
| 1157F | 0% | 3,076 | $0.00 | |
| 3079F | 0% | 1,155 | $0.00 | |
| 3354F | 0% | 29 | $0.00 | |
| 3044F | 0% | 315 | $0.00 | |
| 1101F | 0% | 48 | $0.00 | |
| 99441 | 0% | 1,426 | $0.00 | |
| 4015F | 0% | 28 | $0.00 | |
| 1035F | 0% | 48 | $0.00 | |
| 3048F | 0% | 756 | $0.00 | |
| 2000F | 0% | 613 | $0.00 | |
| 3061F | 0% | 362 | $0.00 | |
| 2001F | 0% | 249 | $0.00 | |
| 4037F | 0% | 354 | $0.00 | |
| 3353F | 0% | 95 | $0.00 | |
| 3352F | 0% | 137 | $0.00 | |
| 3066F | 0% | 252 | $0.00 | |
| 3011F | 0% | 117 | $0.00 | |
| 99386 | 0% | 259 | $0.00 | |
| 2010F | 0% | 302 | $0.00 | |
| 1000F | 0% | 13 | $0.00 | |
| 99384 | 0% | 53 | $0.00 | |
| 1034F | 0% | 27 | $0.00 | |
| 3014F | 0% | 20 | $0.00 | |
| 1110F | 0% | 14 | $0.00 | |
| 1111F | 0% | 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 officialCHEVRES, ITZA (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Family Health Clinic of Caribbean, INC | Toa Alta, PR | $7K |
| Centro Imagenes Radiologia Toa Alta | Toa Alta, PR | $1K |
| Toa Alta Family Clinic LLC | Toa Alta, PR | $1K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.