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NPI 1013140383 · Mayaguez, PR · General Acute Care Hospital
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Mayaguez Medical Center Dr Ramon Emeterio Betances Inc is a general acute care hospital provider located in Mayaguez, Puerto Rico. This profile covers 0 Medicare and 77 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Mayaguez Medical Center Dr Ramon Emeterio Betances Inc |
| Address | Ave Hostos |
| City | Mayaguez |
| State | PR |
| ZIP | 00682 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | September 2, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $7.1M |
| Medicare | $0 |
This provider has no Medicare billing on file and reports $7.1M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer (Medicaid) based on the available claims data. Analysts should treat Medicaid as the sole observed revenue stream when evaluating payer exposure and contracting leverage.
Revenue is highly concentrated: the precomputed top three Medicaid codes account for 54.4% of the provider's total Medicaid revenue. Specifically, 99283 drives $2M (30.6%), 74176 drives $1M (15.6%), and 70450 drives $546.4K (8.2%), indicating a small set of services produce the majority of recorded Medicaid dollars.
The code mix points to a service model centered on emergency care and high-volume diagnostic imaging. 99283 (ED E/M) combined with high volumes of CT of the abdomen/pelvis (74176) and CT head (70450) suggest the facility operates a busy emergency department with on-site CT capability and substantial acute diagnostic throughput. This pattern is consistent with an acute care hospital functioning as an ED and imaging hub for Medicaid patients.
99283 is an outlier in-state: the provider submitted 55.4K claims for 99283 and ranks #5 of 495 providers in Puerto Rico (99th percentile; labeled an "extreme outlier"). That combination of claim volume and rank indicates unusually high ED visit volume for this specific E/M level relative to other in-state providers and is the single largest Medicaid revenue driver here.
Imaging volumes are also prominent but vary by modality. 74176 (6.6K claims, $1M, 15.6% of Medicaid revenue) ranks #5 of 77 providers in-state (95th percentile; "notably above typical"), while 70450 (6.4K claims, $546.4K, 8.2%) ranks #9 of 80 (90th percentile; "typical, unremarkable"). These ranks show the provider is a leading CT abdomen/pelvis performer statewide and a solid performer for CT head, reinforcing an imaging-focused operational profile.
Beyond the top three, the provider shows multiple high-percentile or top-ranked codes that broaden its service footprint. Examples include 99203 ($281.3K, 4.2%) ranked #23 of 1397 (98th percentile; "extreme outlier") for new patient E/M visits, 93010 ($85.2K, 1.3%) ranked #8 of 510 (99th percentile; "extreme outlier") for ECG interpretation, and 69210 ($70.2K, 1.0%) ranked #1 of 32 (100th percentile; "extreme outlier") for ear canal wax removal. Together these suggest substantial outpatient/new-patient throughput, cardiology testing volume, and certain ENT procedure volumes in addition to ED and imaging services.
The heavy reliance on a few high-volume ED and imaging codes implies operational and reimbursement sensitivity: any shifts in Medicaid imaging coverage, ED triage patterns, or utilization management focused on these codes could disproportionately impact the provider's revenue. Given $7.1M in Medicaid receipts and 54.4% of that concentrated in three codes, payers and financial analysts should prioritize those service lines when modeling revenue risk or negotiating rate changes.
The provider has an established presence with its NPI enumerated 2009-09-02 (~17 years ago). Coupled with the high statewide ranks and extreme outlier status on several codes, this tenure and utilization profile indicate the facility is a major Medicaid service provider in Puerto Rico for emergency and imaging services, and a consequential participant in select outpatient and diagnostic lines.
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
77 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99283 | The 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. | 55,400 | $40 | $2M |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 6,620 | $160 | $1M |
| 70450 | The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities. | 6,350 | $90 | $546.4K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 2,960 | $180 | $540.8K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 2,280 | $170 | $375.5K |
| 99213 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the… | 6,160 | $50 | $295.8K |
| 99203 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider… | 4,770 | $60 | $281.3K |
| 70551 | The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam. | 1,020 | $140 | $147.3K |
| 70553 | In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows… | 850 | $170 | $146.4K |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 20,450 | $10 | $143.1K |
Showing 1–10 of 77
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
77 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 76811 | The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic… | 11 | 20 | 910 | $110 | $303K |
| 74176 | The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 5 | 80 | 900 | $110 | $242K |
| 93306 | The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent… | 27 | 210 | 380 | $210 | $230.1K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 11 | 70 | 730 | $110 | $178.7K |
| 78452 | In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood… | 6 | 20 | 260 | $250 | $174.9K |
| 76641 | In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images. | 167 | 180 | 890 | $70 | $145.5K |
| 70450 | The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities. | 9 | 80 | 1,150 | $50 | $125.5K |
| 31525 | The provider uses a laryngoscope to look directly inside the larynx, which is the voice box, to detect any abnormality. He may or may not perform tracheoscopy to visualize the trachea, which is the… | 4 | 10 | 290 | $170 | $123.8K |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 7 | 10 | 300 | $160 | $104.5K |
| 99283 | The 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. | 5 | 500 | 220 | $40 | $79.5K |
Showing 1–10 of 77
Other providers in the same ZIP code as Mayaguez Medical Center Dr Ramon Emeterio Betances Inc, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| West Eye Specialists, LLC | PR | Retina Specialist (Ophthalmology) Physician | $0 | $2.3M |
| West Cardio General Anesthesia Csp | PR | Anesthesiology Physician | $0 | $2.3M |
| Adriana Mendez Sanchez | PR | Neurology with Special Qualifications in Child Neurology Physician | $0 | $835.7K |
| Hgr Paramedic Transport Inc | PR | Ambulance | $20K | $722.4K |
| Jose A. Cancio Md, C.s.p. | PR | Specialist | $0 | $624.1K |
| Juan Almodovar | PR | Ophthalmology Physician | $11.3K | $509.5K |
| Myrna E Montalvo Castillo | PR | Clinical Medical Laboratory | $12.4K | $393.2K |
| Walgreen Co | PR | Pharmacy | $106.7K | $0 |
| Alberto Guardiola | PR | Ophthalmology Physician | $22.6K | $83.8K |
| Monica Egozcue-dionisi | PR | Pulmonary Disease Physician | $11.5K | $26K |
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