Physician

Andres Miguel Ponce, M.D.

According to 2025 Medicare claims, Andres Ponce, M.D. (NPI: 1568859924) practices rheumatology in the Philadelphia, PA market, with the plurality of this provider's patient population coming from Philadelphia, PA. This provider's primary affiliated billing organization is JEFFERSON UNIVERSITY PHYSICIANS (NPI: 1326093675; TIN: 232809585) and primary practice location at 19112-1017. Ponce is affiliated with the Delaware Valley ACO (ACO ID: A2024), participating under the MSSP model.

Ponce's data goes back to 2015 and runs through 2024. For example, in 2024, this provider had 286 traditional Medicare patients, billed 516 HCPCS/CPT codes, and received $39,881 in Medicare payments. The top billing code was 99222 (Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes). Part D data shows 1,894 prescription claims across 289 beneficiaries totaling $3,935,794 in drug costs, led by Enbrel Sureclick (Etanercept). 2017 DME data shows 24 claims. No Open Payments records. You can download detailed data with all billing codes (2015-2024). For more recent data, please contact us.

Over the past 10 years, this provider's Medicare Part B carrier billing did not follow a clear longitudinal pattern. Concurrently, Part D prescription costs have moved sharply higher in recent years, from $26,134 to $3,935,794. For DME billing, this provider has fewer than 5 years of reported data, so a reliable trend cannot be assigned.

Part B Carrier Billing Trend

Medicare payment trend, with N of patients and claim lines in the table.

Year	Patients	Clm Lines	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	N/R	N/R
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	83	104	$9,322
2021	222	444	$38,477
2022	258	575	$47,146
2023	265	492	$42,257
2024	286	516	$39,881

Part D Events Trend

Drug cost trend, with N of patients and prescription claims in the table.

Year	Patients	Claims	Drug Cost
2015	26	102	$26,134
2016	32	248	$11,756
2017	29	303	$11,886
2018	99	399	$69,659
2019	104	456	$119,392
2020	124	416	$245,534
2021	215	816	$835,411
2022	281	1,445	$2,125,233
2023	283	1,697	$2,974,653
2024	289	1,894	$3,935,794

DME Billing Trend

Medicare payment trend, with N of patients and DME claim records in the table.

Year	Patients	Claims	Payment
2015	N/R	N/R	N/R
2016	N/R	N/R	N/R
2017	N/R	24	$825
2018	N/R	N/R	N/R
2019	N/R	N/R	N/R
2020	N/R	N/R	N/R
2021	N/R	N/R	N/R
2022	N/R	N/R	N/R
2023	N/R	N/R	N/R
2024	N/R	N/R	N/R

* / # = suppressed by CMS; 0 = reported zero; N/R = not reported or blank.

Top 5 Part B carrier billing codes in 2024

By total payments.

Code	Description	Patients	Clm Lines	Total Payment
99222	Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	15	15	$104
99204	New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	40	40	$103
99215	Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	64	84	$95
99214	Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	196	283	$72
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	12	12	$13

Top 5 Part D drugs in 2024

By total drug costs.

Drug	Generic	Claims	Total Day Supply	Total Drug Cost
Enbrel Sureclick	Etanercept	142	4,032	$1,041,833
Humira(Cf) Pen	Adalimumab	76	2,400	$588,682
Hyqvia	Igg/Hyaluronidase,recombinant	13	364	$369,894
Rinvoq	Upadacitinib	54	1,620	$336,579
Orencia Clickject	Abatacept	42	1,344	$268,532

Top 5 DME services in 2024

No connected or detailed DME service-level records for 2024.

Open Payments Summary

No connected Open Payments records were found for this physician in General Payments, Research Payments, or Ownership / Investment Interests.

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FAQ

What Medicare data is available for Andres Miguel Ponce, M.D.?

Tedicare shows public-source Medicare data for Andres Miguel Ponce, M.D. (NPI 1568859924), including provider identity, specialty, market context, Medicare Part B activity, Part D prescribing, DME records, Open Payments where available, billing organization details, and ACO affiliation signals where available. Profile data covers 2015-2024, with current attribution based on 2025 claims where available.

Does Andres Miguel Ponce, M.D. have ACO affiliation data?

Andres Miguel Ponce, M.D. is shown with ACO affiliation data for Delaware Valley ACO (MSSP, ACO ID A2024).

What billing organization is linked to Andres Miguel Ponce, M.D.?

Andres Miguel Ponce, M.D. is linked to JEFFERSON UNIVERSITY PHYSICIANS (billing NPI 1326093675) in the available physician profile data.

Does Andres Miguel Ponce, M.D. have Open Payments data?

No connected Open Payments records are shown for this physician in the available General Payments, Research Payments, or Ownership / Investment Interests data.

Can I download physician-level Medicare data from Tedicare?

Yes. Tedicare provides sample physician export data and paid custom physician data exports for research, planning, outreach, and market analysis. Exports can include physician profile fields, market and specialty context, billing organization details, ACO affiliation signals where available, and Medicare utilization data.