PROVIDER PROFILE · NPI 1609028612

Rafael RafolsM.D.

Family PracticeEdinburg, TXI

MEDICARE UTILIZATION · PART B · 2024

Total beneficiaries

793

Unique beneficiaries

—

Total services

2,757

Distinct HCPCS

Medicare payment

$176K

Peer benchmark

Total Medicare services vs. 6,385 Family Practice providers in TX — top quintile (cohort median 567).

PRESCRIBING · PART D · 2024

Total Rx claims

506

Beneficiaries

—

Total drug cost

$129K

Distinct drugs

Brand share

44.1%

Top prescribed drugs

Collagenase Clostridium Hist.163 claims

Doxycycline Hyclate118 claims

Amoxicillin/Potassium Clav42 claims

Gentamicin Sulfate40 claims

Levofloxacin32 claims

QUALITY · MIPS · 2024

Final MIPS score

75.0

Quality

0.0

Cost

17.4

Improvement activities

0.0

Promoting interop.

0.0

Payment adjustment

0.00%

Individual

INDUSTRY PAYMENTS · OPEN PAYMENTS · 2024

Total received

$8K

Payment records

By payment type

Consulting Fee$6K

Food and Beverage$981

Travel and Lodging$771

REFERRAL NETWORK

Where Rafael Rafols's patients come from & go

Directional shared-patient flow from Medicare claims — who sends patients to this provider (inbound) and where this provider's patients go next (outbound). 148 inbound referrers · 0 outbound destinations.

Receives referrals from

Inbound — who sends patients here

Physician	Patients	Visits
DOCTORS HOSPITAL AT RENAISSANCE, LTD	536	5,947
Vangala Reddy Diagnostic Radiology · Edinburg, TX	208	1,573
Med Care Emergency Medical Services Inc Ambulance Service Provider · Mcallen, TX	198	747
HIDALGO COUNTY EMERGENCY SERVICE FOUNDATION	189	1,356
Eliana Ochoa Infectious Disease · Mcallen, TX	169	2,027
Fire Emergency Medical Services Llc Ambulance Service Provider · Mcallen, TX	151	980
Ruben Mohme Internal Medicine · Edinburg, TX	144	954
Manuel Seas Internal Medicine · Edinburg, TX	139	1,143
Barry Cook Diagnostic Radiology · Mcallen, TX	133	1,321
GRAHAM, FRANKLIN	131	699
Luis Gonzalez Peniza Internal Medicine · Mcallen, TX	125	1,307
Jose Lopez Family Practice · Edinburg, TX	121	939

Refers patients to

Outbound — where patients go next

No outbound pairs above the suppression threshold.

Source: CMS Physician Shared Patient Patterns (30-day window, Medicare FFS). Direction = a beneficiary seen by the first provider, then the second, within 30 days; a proxy for referral, not a documented referral. Pairs with fewer than 11 shared beneficiaries are suppressed.

CROSS-REFERENCE

Related data on other Healthparse brands

ProviderScore

OIG/SAM exclusion screening, sanctions history