Managed care
Med Caribe CSP
Med Caribe CSP was paid $137K by Medicaid between Jan 2018 and Dec 2024, across 42 billing codes. Its largest line is 96160, — 48% of everything it billed.
33Billing provider infoMED CARIBE CSP
SAN JUAN, PR 00920
SAN JUAN, PR 00920
33aNPI1962564773assigned 12/15/2006
33bProvider typeExclusive Provider Organization
28Total paid$137K
24GClaims99,637
24DCodes billed42
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Exclusive Provider Organization providers in Puerto Rico
Rank by total paid#11 of 19
Median peer was paid$250K
This provider vs. median0.5×
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 | 10,942 | $12K | |
| 2019 | 16,739 | $15K | |
| 2020 | 11,000 | $8K | |
| 2021 | 12,617 | $12K | |
| 2022 | 14,338 | $19K | |
| 2023 | 15,157 | $43K | |
| 2024incomplete | 18,844 | $28K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 96160 | 48% | 2,281 | 2,250 | $66K | |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 26% | 39,275 | 32,005 | $36K |
| 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 | 14% | 2,822 | 2,577 | $19K |
| 99442 | 4.0% | 9,647 | 8,684 | $5K | |
| 99441 | 2.7% | 17,679 | 15,757 | $4K | |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 2.0% | 307 | 298 | $3K |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | 1.8% | 289 | 274 | $2K |
| 99443 | <1% | 1,141 | 1,039 | $670.16 | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 498 | 476 | $321.00 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 950 | 886 | $305.76 |
| 88150 | <1% | 515 | 503 | $205.20 | |
| 99348 | <1% | 12 | 12 | $160.00 |
30 more codes
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 51 | $118.45 |
| 90791 | Psychiatric diagnostic evaluation | <1% | 72 | $40.00 |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 121 | $23.69 |
| 1159F | 0% | 2,894 | $0.00 | |
| 3078F | 0% | 4,125 | $0.00 | |
| 1160F | 0% | 2,315 | $0.00 | |
| 3077F | 0% | 1,074 | $0.00 | |
| 0521F | 0% | 12 | $0.00 | |
| 99401 | 0% | 16 | $0.00 | |
| 3050F | 0% | 13 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 24 | $0.00 |
| 90837 | Psychotherapy session, about an hour | 0% | 15 | $0.00 |
| 3074F | 0% | 3,797 | $0.00 | |
| 3079F | 0% | 1,259 | $0.00 | |
| 3008F | 0% | 6,130 | $0.00 | |
| 3017F | 0% | 173 | $0.00 | |
| 3044F | 0% | 157 | $0.00 | |
| 3080F | 0% | 281 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 300 | $0.00 |
| 96127 | 0% | 121 | $0.00 | |
| 3075F | 0% | 763 | $0.00 | |
| 3011F | 0% | 268 | $0.00 | |
| 3049F | 0% | 32 | $0.00 | |
| 3048F | 0% | 117 | $0.00 | |
| 1125F | 0% | 24 | $0.00 | |
| 88141 | 0% | 16 | $0.00 | |
| 96150 | 0% | 13 | $0.00 | |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 12 | $0.00 |
| 99344 | 0% | 13 | $0.00 | |
| 99386 | 0% | 13 | $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 officialCANDELAS, HECTOR (PRESIDENT)
| Provider | Location | Paid |
|---|---|---|
| Metro Medical Health Group, INC. | Bayamon, PR | $3K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.