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    v1.0.28
    OpenPayerNPI Medicare & MedicaidAlvaro Toledo Rivera
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    Alvaro Toledo Rivera — Billing Profile & Reimbursement Data

    NPI 1811275761 · Danville, PA · Internal Medicine Physician

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    Alvaro Toledo Rivera is a internal medicine physician provider located in Danville, Pennsylvania. This profile covers 14 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAlvaro Toledo Rivera
    Address100 North Academy Ave
    CityDanville
    StatePA
    ZIP17822
    TaxonomyInternal Medicine Physician
    NPI EnumeratedJuly 26, 2011

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$201.4K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99223The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…300$140$43K
    99232The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…620$60$38.7K
    99233The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…240$90$22.7K
    99308The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…360$60$21.1K
    99239The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…200$90$17.8K
    99231The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…320$40$12.1K
    99238The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…190$60$12K
    99305The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…100$100$10.6K
    99309The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…90$70$6.5K
    99310The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…50$120$6.2K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    993091,1101,660170$80$27.4K
    993082881,480110$50$14.3K
    9931043278060$110$13.8K
    992339686,63070$90$12K
    9930657076050$140$11.4K
    9923242210,87080$60$9.6K
    99223887,02040$130$7.8K
    9930510960040$100$6.8K
    992391503,25060$90$6.6K
    992226,0207,85030$100$4.3K

    Showing 1–10 of 14

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Alvaro Toledo Rivera, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Bayhealth Medical Center, Inc.DEGeneral Acute Care Hospital$0$79.3M
    Bayhealth Medical Center, Inc.DEGeneral Acute Care Hospital$0$39.5M
    Bayhealth Emergency Physicians LLCDEEmergency Medicine Physician$0$16.7M
    Christiana Care Health Services IncDEHospitalist Physician$0$13.6M
    Bayhealth Medical Center, IncDEColon & Rectal Surgery Physician$0$12.4M
    Apogee Medical Group, Delaware, IncDEInternal Medicine Physician$0$7.9M
    Bayhealth Medical Center, Inc.DEClinic/Center$0$3.7M
    Inpatient Consultants Of Delaware, LLCDEHospitalist Physician$0$1.5M
    Tyler YerkesDEPhysician Assistant$1.1M$0
    Delaware Post Acute Medical Services 1DEHospitalist Physician$0$897.8K

    Nearby Providers

    Other providers in the same ZIP code as Alvaro Toledo Rivera, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Geisinger ClinicPASurgery Physician$0$74.6M
    Geisinger Medical CenterPAGeneral Acute Care Hospital$0$27.8M
    Geisinger Clinic - Outpatient PsychPACounselor$0$19.6M
    Geisinger ClinicPADiagnostic Radiology Physician$0$14.9M
    Geisinger Medical CenterPAAir Ambulance$0$6.6M
    George LinPAAnatomic Pathology & Clinical Pathology Physician$1.2M$0
    Christopher CessnaPAOphthalmology Physician$1.2M$0
    Rasoul MokabberiPACardiovascular Disease Physician$613.5K$590
    Bryan MartinPACardiovascular Disease Physician$449.7K$770
    Frank MerchoPADiagnostic Radiology Physician$423.9K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Pennsylvania Distribution
    Alvaro Toledo Rivera — 5 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Pennsylvania