Managed care
Aco Del Norte LLC
Aco Del Norte LLC was paid $1.90M by Medicaid between Jan 2018 and Dec 2024, across 87 billing codes. Its largest line is 96160, — 41% of everything it billed.
33Billing provider infoACO DEL NORTE LLC
ARECIBO, PR 00612
ARECIBO, PR 00612
33aNPI1942515440assigned 08/10/2010
33bProvider typeHealth Maintenance Organization
28Total paid$1.90M
24GClaims1,666,225
24DCodes billed87
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Health Maintenance Organization providers in Puerto Rico
Rank by total paid#1 of 37
Median peer was paid$25K
This provider vs. median75×
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 | 108,871 | $15K | |
| 2019 | 178,632 | $44K | |
| 2020 | 176,679 | $142K | |
| 2021 | 226,763 | $380K | |
| 2022 | 267,622 | $390K | |
| 2023 | 307,422 | $549K | |
| 2024incomplete | 400,236 | $379K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96160 | 41% | 27,367 | 26,205 | $787K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 16% | 751,778 | 560,519 | $295K |
| 76830 | Ultrasound, transvaginal | 15% | 4,604 | 4,403 | $284K |
| Q0091 | Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory | 9.0% | 13,710 | 12,998 | $171K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 4.4% | 236,352 | 173,092 | $84K |
| 99442 | 3.4% | 94,938 | 71,986 | $65K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 2.6% | 1,542 | 1,499 | $49K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.5% | 10,536 | 10,171 | $48K |
| 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 | 2.3% | 117,352 | 82,995 | $43K |
| 58558 | 1.6% | 344 | 335 | $30K | |
| 57454 | <1% | 470 | 466 | $12K | |
| 99441 | <1% | 54,996 | 43,919 | $11K |
75 more codes
| 99443 | <1% | 10,031 | $6K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 3,361 | $6K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 1,553 | $3K |
| 99050 | <1% | 197 | $1K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 6,520 | $930.84 |
| 57460 | <1% | 14 | $394.88 | |
| G2010 | Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, 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 | <1% | 1,963 | $164.31 |
| 99201 | <1% | 528 | $160.00 | |
| 99347 | <1% | 1,933 | $120.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 582 | $47.52 |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 189 | $30.60 |
| 99244 | Office or other outpatient consultation, moderate to high complexity | <1% | 119 | $25.00 |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 143 | $0.05 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 234 | $0.04 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 91 | $0.01 |
| 1158F | 0% | 6,445 | $0.00 | |
| 3078F | 0% | 48,111 | $0.00 | |
| 1160F | 0% | 21,825 | $0.00 | |
| 3077F | 0% | 2,029 | $0.00 | |
| 1159F | 0% | 31,775 | $0.00 | |
| 3725F | 0% | 3,483 | $0.00 | |
| 3050F | 0% | 2,093 | $0.00 | |
| 0521F | 0% | 1,042 | $0.00 | |
| 1033F | 0% | 457 | $0.00 | |
| 99408 | 0% | 1,100 | $0.00 | |
| 1090F | 0% | 515 | $0.00 | |
| 3051F | 0% | 721 | $0.00 | |
| 3046F | 0% | 637 | $0.00 | |
| 90791 | Psychiatric diagnostic evaluation | 0% | 31 | $0.00 |
| 4035F | 0% | 265 | $0.00 | |
| 99401 | 0% | 12 | $0.00 | |
| 3045F | 0% | 42 | $0.00 | |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 136 | $0.00 |
| 3288F | 0% | 274 | $0.00 | |
| 2028F | 0% | 41 | $0.00 | |
| 1124F | 0% | 52 | $0.00 | |
| 99173 | 0% | 295 | $0.00 | |
| 96152 | 0% | 96 | $0.00 | |
| 99411 | 0% | 49 | $0.00 | |
| 99382 | 0% | 14 | $0.00 | |
| 3061F | 0% | 2,779 | $0.00 | |
| 1157F | 0% | 7,907 | $0.00 | |
| 1125F | 0% | 15,335 | $0.00 | |
| 1170F | 0% | 12,019 | $0.00 | |
| 4010F | 0% | 1,484 | $0.00 | |
| 3079F | 0% | 9,443 | $0.00 | |
| 3074F | 0% | 56,067 | $0.00 | |
| 3008F | 0% | 51,160 | $0.00 | |
| 3017F | 0% | 6,120 | $0.00 | |
| 1126F | 0% | 9,542 | $0.00 | |
| 3080F | 0% | 203 | $0.00 | |
| 3075F | 0% | 4,338 | $0.00 | |
| 1111F | 0% | 3,423 | $0.00 | |
| 3048F | 0% | 5,583 | $0.00 | |
| 88150 | 0% | 662 | $0.00 | |
| 3044F | 0% | 7,689 | $0.00 | |
| 3014F | 0% | 1,781 | $0.00 | |
| 99341 | 0% | 24 | $0.00 | |
| 3049F | 0% | 3,021 | $0.00 | |
| 1036F | 0% | 462 | $0.00 | |
| 96161 | 0% | 36 | $0.00 | |
| 3060F | 0% | 723 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 1,554 | $0.00 |
| 1022F | 0% | 146 | $0.00 | |
| 1030F | 0% | 653 | $0.00 | |
| 92551 | 0% | 356 | $0.00 | |
| 3052F | 0% | 245 | $0.00 | |
| 90839 | 0% | 47 | $0.00 | |
| 99383 | 0% | 91 | $0.00 | |
| 99385 | 0% | 12 | $0.00 | |
| 88142 | 0% | 139 | $0.00 | |
| 96150 | 0% | 24 | $0.00 | |
| 99205 | Prolong outpt/office vis | 0% | 83 | $0.00 |
| 99384 | 0% | 57 | $0.00 | |
| 96127 | 0% | 30 | $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 officialGONZALEZ, SEGUNDO (PRESIDENT)