Caballero-Torres, Rafael
Caballero-Torres, Rafael was paid $544K by Medicaid between Jan 2018 and Nov 2024, across 5 billing codes. Its largest line is 99204, doctor's office visit, new patient (more involved) — 65% of everything it billed.
33Billing provider infoCABALLERO-TORRES, RAFAEL
GUAYAMA, PR 00784
GUAYAMA, PR 00784
33aNPI1942269543assigned 03/22/2006
33bProvider typeSpecialist
28Total paid$544K
24GClaims6,937
24DCodes billed5
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Specialist providers in Puerto Rico
Rank by total paid#39 of 316
Median peer was paid$26K
This provider vs. median21×
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 | 965 | $29K | |
| 2019 | 1,012 | $32K | |
| 2020 | 772 | $50K | |
| 2021 | 1,030 | $85K | |
| 2022 | 1,111 | $100K | |
| 2023 | 1,076 | $136K | |
| 2024incomplete | 971 | $112K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 65% | 3,577 | 3,333 | $352K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 33% | 3,259 | 2,948 | $182K |
| 31525 | 1.7% | 59 | 58 | $9K | |
| 30200 | <1% | 14 | 14 | $636.00 | |
| 1159F | 0% | 28 | 28 | $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.