Luis Melgar Physician, PC

Luis Melgar Physician, PC was paid $488K by Medicaid between Jan 2018 and Dec 2024, across 20 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 47% of everything it billed.

33Billing provider infoLUIS MELGAR PHYSICIAN, PC
HAMBURG, NY 14075

33aNPI1982822664assigned 04/20/2007

33bProvider typeAllergy & Immunology (Internal Medicine) Physician

28Total paid$488K

24GClaims9,860

24DCodes billed20

24AFirst – last monthJan 2018 – Dec 2024

Compared with peers

Next to other Allergy & Immunology (Internal Medicine) Physician providers in New York

Rank by total paid#3 of 22

Median peer was paid$19K

This provider vs. median26×

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	867	$59K
2019	1,314	$69K
2020	1,683	$72K
2021	1,903	$85K
2022	1,554	$81K
2023	1,716	$71K
2024incomplete	823	$52K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	47%	4,391	3,898	$227K
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	34%	2,618	2,479	$166K
99223	Prolong inpt eval add15 m	8.8%	301	299	$43K
99233	Hospital visit by a doctor, follow-up day (complex)Prolong inpt eval add15 m	4.1%	279	159	$20K
99232	Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity	2.2%	205	107	$11K
95117		1.5%	939	534	$7K
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	<1%	26	26	$3K
99396	Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years	<1%	27	26	$2K
99395	Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years	<1%	32	30	$2K
99222	Initial hospital care, per day, moderate complexity	<1%	13	13	$1K
G0444	Annual depression screening, 5 to 15 minutes	<1%	356	356	$1K
G0442	Annual alcohol misuse screening, 5 to 15 minutes	<1%	339	339	$902.49

8 more codes

90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	<1%	94	$825.13
90674		<1%	35	$667.21
90686		<1%	32	$654.41
99442		<1%	18	$424.87
99080		0%	56	$0.00
99499		0%	45	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	29	$0.00
G8419	Bmi documented outside normal parameters, no follow-up plan documented, no reason given	0%	25	$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 officialMELGAR, LUIS (PHYSICIAN)