Clinic
Agustin Martinez M D P a
Agustin Martinez M D P a was paid $347K by Medicaid between Dec 2018 and Dec 2024, across 32 billing codes. Its largest line is 99232, hospital visit by a doctor, follow-up day — 28% of everything it billed.
33Billing provider infoAGUSTIN MARTINEZ M D P A
HIALEAH, FL 33013
HIALEAH, FL 33013
33aNPI1992892558assigned 10/06/2006
33bProvider typePrimary Care Clinic/Center
28Total paid$347K
24GClaims58,924
24DCodes billed32
24AFirst – last monthDec 2018 – Dec 2024
Compared with peers
Next to other Primary Care Clinic/Center providers in Florida
Rank by total paid#39 of 215
Median peer was paid$25K
This provider vs. median14×
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 | 212 | $780.92 | |
| 2019 | 4,313 | $8K | |
| 2020 | 3,604 | $4K | |
| 2021 | 12,821 | $49K | |
| 2022 | 12,205 | $30K | |
| 2023 | 12,525 | $134K | |
| 2024incomplete | 13,244 | $121K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 28% | 10,337 | 2,170 | $96K |
| 99349 | 24% | 1,889 | 1,734 | $84K | |
| 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% | 2,675 | 1,856 | $35K |
| 99348 | 9.6% | 1,197 | 1,122 | $33K | |
| 99222 | Initial hospital care, per day, moderate complexity | 8.3% | 1,698 | 1,125 | $29K |
| 99490 | Ccm add 20min | 6.4% | 9,725 | 8,058 | $22K |
| 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 | 5.7% | 520 | 453 | $20K |
| 99308 | Subsequent nursing facility care, per day, straightforward | 3.4% | 2,021 | 1,657 | $12K |
| 99335 | 2.8% | 1,144 | 986 | $10K | |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 271 | 187 | $3K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 14 | 14 | $1K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 13 | 13 | $963.00 |
20 more codes
| 99385 | <1% | 14 | $873.07 | |
| 97550 | <1% | 13 | $43.97 | |
| 99439 | <1% | 77 | $31.79 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 135 | $1.16 |
| 3074F | <1% | 3,718 | $0.02 | |
| 1170F | <1% | 771 | $0.01 | |
| G8417 | Bmi is documented above normal parameters and a follow-up plan is documented | 0% | 2,105 | $0.00 |
| 3078F | 0% | 3,630 | $0.00 | |
| 3288F | 0% | 1,199 | $0.00 | |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 3,382 | $0.00 |
| 0518F | 0% | 1,224 | $0.00 | |
| 1160F | 0% | 12 | $0.00 | |
| 1159F | 0% | 14 | $0.00 | |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 3,358 | $0.00 |
| 2000F | 0% | 6,511 | $0.00 | |
| 1101F | 0% | 1,033 | $0.00 | |
| 3079F | 0% | 59 | $0.00 | |
| 1125F | 0% | 14 | $0.00 | |
| 1036F | 0% | 138 | $0.00 | |
| 1123F | 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 officialMARTINEZ, AGUSTIN (PHYSICIAN)
| Provider | Location | Paid |
|---|---|---|
| Edinburg Obstetrics, Gyneceology & Infertility Clinic PA | Edinburg, TX | $99K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.