Carvalho, Gerard

Carvalho, Gerard was paid $765K by Medicaid between Jan 2018 and Oct 2024, across 6 billing codes. Its largest line is 31231, — 43% of everything it billed.

33Billing provider infoCARVALHO, GERARD
HEMET, CA 92543

33aNPI1992721054assigned 07/14/2006

33bProvider typeOtolaryngology Physician

28Total paid$765K

24GClaims5,699

24DCodes billed6

24AFirst – last monthJan 2018 – Oct 2024

Compared with peers

Next to other Otolaryngology Physician providers in California

Rank by total paid#24 of 168

Median peer was paid$67K

This provider vs. median11×

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	2,199	$250K
2019	414	$43K
2020	535	$69K
2021	568	$90K
2022	749	$119K
2023	651	$99K
2024incomplete	583	$94K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
31231		43%	1,690	1,664	$326K
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	25%	1,603	1,569	$188K
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	13%	619	618	$98K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	10%	1,107	1,035	$80K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	8.1%	583	565	$62K
31575		1.4%	97	93	$11K

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.