Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJose Rivera Velazquez
    Ask Trek AI about this page

    Jose Rivera Velazquez — Billing Profile & Reimbursement Data

    NPI 1851300727 · Cayey, PR · Pediatrics Physician

    Customize your policy alerts

    Sign up for Jose Rivera Velazquez — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Jose Rivera Velazquez is a pediatrics physician provider located in Cayey, Puerto Rico. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJose Rivera Velazquez
    AddressRoad 14 Km. 3.1
    CityCayey
    StatePR
    ZIP00737
    TaxonomyPediatrics Physician
    NPI EnumeratedAugust 7, 2006

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

    Payer SourceTotal Paid
    Medicaid$818.4K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

    Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

    13 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99235The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…1,880$110$197.5K
    99220N/A1,840$90$167.2K
    99284The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.1,260$110$131.9K
    99245The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…2,590$30$80.2K
    99283The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.1,080$60$64.6K
    99234The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…550$100$55.5K
    99285The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.340$140$47.3K
    99241Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…500$50$22.5K
    99218N/A640$30$21.2K
    99236The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…80$200$15.2K

    Showing 1–10 of 13

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Puerto Rico median

    13 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    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…358390290$80$96.8K
    99235The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…15160310$120$81.8K
    99284The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.67340210$70$81.7K
    99283The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.116500220$40$79.5K
    99234The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…84220320$80$66.7K
    99285The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.65180170$80$55.3K
    99236The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…539090$150$50.7K
    99220N/A480160$120$48K
    99245The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…1190190$30$32.6K
    99218N/A32120180$50$26.2K

    Showing 1–10 of 13

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Centro Medico Del Turabo IncPRMulti-Specialty Clinic/Center$0$10.8M
    John DanetPRPediatric Emergency Medicine (Pediatrics) Physician$0$2.7M
    Luis AcostaPRPediatrics Physician$0$2.2M
    Jesus Romero PerezPRDiagnostic Radiology Physician$8.1K$1.4M
    Pedro Rivera CaballeroPRGeneral Practice Physician$3.1K$1.3M
    Juan Benitez SantanaPRGeneral Practice Physician$3.6K$1.3M
    Francisco Menendez DiazPRGeneral Practice Physician$0$986.8K
    Rejee AreeckalPRGeneral Practice Physician$0$704.1K
    Zoraida Estela JovePRDiagnostic Radiology Physician$18.1K$255.1K
    Juan Malpica-santiagoPRPulmonary Disease Physician$33.2K$148.3K

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Hospital Menonita De CayeyPRSpecialist$0$2.4M
    Laboratorio Clinico Lopez Rivera CspPRClinical Medical Laboratory$21.4K$2.4M
    Hospital Menonita De CayeyPRGeneral Acute Care Hospital$0$1.8M
    Wilfredo De Jesus RojasPRPediatric Pulmonology Physician$0$1.2M
    Puerto Rico Cardiac Arrhythmia Management LLCPRClinical Cardiac Electrophysiology Physician$0$639.9K
    Jose Marcial SuarezPRClinical Cardiac Electrophysiology Physician$3.9K$250.6K
    Frank AcevedoPRSpecialist$7.9K$89.7K
    Francisco Vazquez ReilloPRNeurology Physician$12.4K$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.

    Medicaid Revenue by Year vs. Puerto Rico Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    Jose Rivera Velazquez — 1 of 12 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico