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.

Caribbean Imaging And Radiation Treatment Center,inc (NPI 1033183603)

Key Findings

Field	Value
Entity Type	Organization
Organization	Caribbean Imaging And Radiation Treatment Center,inc
Address	Ponce By Pass
City	Ponce
State	PR
ZIP	00717
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	February 13, 2006

Payer Source	Total Paid
Medicaid	$19.3M
Medicare	$0

CARIBBEAN IMAGING AND RADIATION TREATMENT CENTER,INC is effectively a Medicaid-focused imaging and radiation practice, reporting $19.3M in lifetime Medicaid revenue and no Medicare billing on file; this makes its commercial/payer mix heavily concentrated in Medicaid rather than split between Medicare and Medicaid. The absence of Medicare revenue on file indicates analysts should treat comparisons against Medicare peer sets as inapplicable for this entity.

Revenue is highly concentrated: the precomputed top three Medicaid codes (77386, 76641, 77067) account for 52.1% of the provider’s total Medicaid revenue. Those three codes alone generated $4.3M (23.9%), $2.6M (14.5%), and $2.4M (13.6%) respectively, highlighting reliance on a small set of high-volume imaging and radiation delivery services.

The code mix indicates a dual operational focus on advanced radiation therapy and high-volume breast imaging. 77386 (IMRT delivery) with 12.4K claims and a $343 avg paid/claim ($4.3M revenue) points to a substantial radiation oncology treatment service line, while 76641 (breast ultrasound) at 25.4K claims and 77067 (screening mammography with CAD) at 24.2K claims — with $102 and $100 avg paid/claim and $2.6M and $2.4M revenue respectively — show large-scale breast imaging operations.

Competitive standing in-state is dominant for several key services: the provider ranks #1 of 5 for 77386 (100th percentile), #1 of 183 for 76641 (100th percentile; labeled an extreme outlier), and #1 of 153 for 77067 (100th percentile; extreme outlier). Numerous additional imaging and MRI codes also show #1 statewide ranks and 100th percentile placements, which collectively characterize the center as a major, perhaps market-leading, provider for both breast imaging and radiation delivery within Puerto Rico.

Multiple Medicaid codes are flagged as statistical outliers or notably above typical state volume: 76641 and 77067 are described as extreme outliers, 77386 is notably above typical state volume, and several other codes (e.g., 76830, 76536, A9579, 72148, 73721) are listed at 100th percentile or similarly extreme placements. These labels indicate volumes that are far above typical in-state peers and should be considered when benchmarking utilization, capacity, or referral patterns.

Operational scale is evident in claim counts in addition to revenue: the provider reports very large claim volumes such as 25.4K claims for 76641, 24.2K claims for 77067, and 12.4K claims for 77386, implying high daily throughput for both imaging and treatment services and supporting the view of an established, high-capacity facility.

While the center shows strength in dominant in-state positioning for its top codes, the business is exposed to concentration risk because a small set of radiation and breast imaging codes generate the majority of Medicaid revenue. If reimbursement, clinical referral patterns, or utilization for 77386, 76641, or 77067 were to shift, a substantial portion of the $19.3M Medicaid revenue base could be affected.

Tenure data show the NPI was enumerated on 2006-02-13 (~20 years ago), indicating long-standing market presence; combined with the high volumes and top statewide ranks, the provider appears to be an established regional center for imaging and radiation services rather than a recent entrant.

Medicaid: Complete Services Breakdown

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

70 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	12,440	$340	$4.3M
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	25,400	$100	$2.6M
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…	24,200	$100	$2.4M
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…	12,350	$120	$1.5M
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	10,290	$90	$905.3K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	7,890	$90	$678.2K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	7,730	$80	$625.8K
A9579	Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml	9,200	$60	$515K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	2,690	$170	$457.5K
G6015	Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session	2,580	$160	$410.2K

Showing 1–10 of 70

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

Caribbean Imaging And Radiation Treatment Center,inc — 20 of 25 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

70 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	1	10	1,430	$330	$1.5M
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.	57	80	900	$110	$242K
77412	The provider delivers radiation therapy at level 3 complexity. This includes photon therapy delivered to multiple isocenters, photon therapy with active motion management, total skin electron…	2	10	760	$70	$198K
77427	Radiation therapy utilizes ionizing radiation beams that are directed at cancerous cells in order to destroy them. The radiation, damages the DNA (the genetic material) in the cell, thus preventing…	2	10	1,170	$110	$185.6K
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.	40	70	730	$110	$178.7K
G6015	Intensity modulated treatment delivery, single or multiple fields/arcs,via narrow spatially and temporally modulated beams, binary, dynamic mlc, per treatment session	1	10	510	$160	$174.9K
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…	1	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.	8	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.	1	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.	62	80	1,150	$50	$125.5K

Showing 1–10 of 70

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Compression Health Care Inc	PR	Oxygen Equipment & Supplies (DME)	$0	$10.6M
Caribbean Cancer Care Services, LLC	PR	Medical Oncology Physician	$0	$6.5M
Oficina Medica Dr Quintero Psc	PR	Specialist	$0	$4.9M
Pet Diagnostic Imaging Corp	PR	Radiology Clinic/Center	$0	$4.8M
Hector Velez Cortes	PR	Hematology & Oncology Physician	$4.3K	$4M
Centro Oncologico De La Mujer De Puerto Rico Csp	PR	Oncology Clinic/Center	$0	$3.8M
Caribbean Wellness Oncology, Psc	PR	Hematology & Oncology Physician	$0	$3.6M
Jose Santiago Alvarado	PR	Anatomic Pathology & Clinical Pathology Physician	$17.2K	$3.2M
Dr German Chaves Radiologo Csp	PR	Diagnostic Radiology Physician	$0	$2.9M
Lydia Irizarry Gonzalez	PR	Pediatric Endocrinology Physician	$0	$2.6M

Caribbean Imaging And Radiation Treatment Center,inc — Billing Profile & Reimbursement Data

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Caribbean Imaging And Radiation Treatment Center,inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References