Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Puerto Rico for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Puerto Rico only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Puerto Rico (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Saint Michael Med Serv Inc (NPI 1023095072)

Field	Value
Entity Type	Organization
Organization	Saint Michael Med Serv Inc
Address	Marginal B 10
City	Manati
State	PR
ZIP	00674
Taxonomy	Surgery Physician
NPI Enumerated	December 29, 2005

Payer Source	Total Paid
Medicaid	$913.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	800	$510	$405.1K
19083	Under ultrasound guidance, the provider takes breast tissue percutaneously from a single lesion for biopsy. He may place a localization device at the same time.	360	$380	$137.2K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	3,250	$40	$130.1K
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…	1,740	$60	$97.7K
76642	In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images.	840	$60	$52.7K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,550	$20	$29.4K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	250	$110	$28.2K
99241	Office 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.…	260	$50	$12.4K
99442	N/A	250	$40	$9.5K
19499	Use this code to report a procedure on the breast for which there is no specific code available.	30	$120	$3.6K

Showing 1–10 of 15

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.

Claims Volume vs. Puerto Rico Distribution

Saint Michael Med Serv Inc — 0 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Puerto Rico

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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	147	150	1,180	$70	$170.3K
19083	Under ultrasound guidance, the provider takes breast tissue percutaneously from a single lesion for biopsy. He may place a localization device at the same time.	4	10	190	$350	$153.1K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	35	180	890	$70	$145.5K
19499	Use this code to report a procedure on the breast for which there is no specific code available.	4	10	370	$270	$112.8K
77066	The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities…	124	130	480	$90	$109.4K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	94	230	410	$40	$51.9K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	187	900	360	$30	$42.5K
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…	845	3,230	330	$10	$42.4K
76642	In this procedure, the provider performs a focused ultrasound of one breast on a limited area. The procedure includes documentation of the images.	2	10	350	$50	$23.4K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	160	530	100	$70	$22.9K

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as Saint Michael Med Serv Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Pathology Csp	PR	Clinical Medical Laboratory	$0	$16.9M
Pci Group LLC	PR	Interventional Cardiology Physician	$0	$9.6M
Centro Cardiovascular De Manati Iii Csp	PR	Cardiovascular Disease Physician	$0	$5.7M
Anestesia Del Norte P.s.c.	PR	Specialist	$0	$5M
Mogic Ob-gyn Psc	PR	Obstetrics & Gynecology Physician	$0	$4.9M
Dorado Health Inc	PR	General Acute Care Hospital	$0	$3.7M
Dentistas Asociados Del Norte	PR	General Practice Dentistry	$0	$3M
Crilomil Corp.	PR	Pediatric Dentistry	$0	$2.8M
Hospitalist Medical Services, Psc	PR	Anesthesiology Physician	$0	$2.7M
Atlantic Pathology	PR	Clinical Medical Laboratory	$0	$2.5M

Saint Michael Med Serv Inc — Billing Profile & Reimbursement Data

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Saint Michael Med Serv Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References