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.

San Jorge Children's Medical Specialties,psc (NPI 1043412752)

San Jorge Children's Medical Specialties,psc is a oncology clinic/center provider located in San Juan, Puerto Rico. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	San Jorge Children's Medical Specialties,psc
Address	252 Calle San Jorge
City	San Juan
State	PR
ZIP	00912
Taxonomy	Oncology Clinic/Center
NPI Enumerated	June 4, 2007

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q0085	Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit	2,730	$240	$654.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	2,470	$80	$187.9K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	900	$130	$119.1K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	980	$120	$118.3K
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…	430	$90	$40.6K
Q0084	Chemotherapy administration by infusion technique only, per visit	40	$360	$12.7K
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…	100	$70	$6.8K
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.…	60	$100	$5.3K
99056	The provider sees the patient at a location outside of the provider’s office to accommodate the needs of the patient.	10	$290	$3.7K
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…	30	$130	$3.4K

Showing 1–10 of 13

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

San Jorge Children's Medical Specialties,psc — 0 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q0085	Chemotherapy administration by both infusion technique and other technique(s) (e.g., subcutaneous, intramuscular, push), per visit	1	10	2,730	$240	$655.3K
Q0084	Chemotherapy administration by infusion technique only, per visit	71	70	900	$80	$219.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	31	70	750	$80	$138K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	20	60	360	$80	$94K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	46	280	210	$30	$43.8K
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…	401	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…	2,209	3,230	330	$10	$42.4K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	84	90	190	$30	$32.6K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	128	160	90	$90	$31.8K
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…	396	530	100	$70	$22.9K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grupo Intensivo Pediatrico De San Juan	PR	Pediatric Critical Care Medicine Physician	$0	$5.5M
Ghp C.s.p.	PR	Pediatrics Physician	$0	$3.6M
Villegas LLC	PR	Ophthalmology Physician	$0	$1.3M
Felix J Seda Ent Psc	PR	Pediatric Otolaryngology Physician	$0	$1.3M
Luis Font	PR	Pediatric Endocrinology Physician	$0	$836.4K
San Jorge Associates	PR	Anesthesiology Physician	$0	$656.6K
Rafael Trinidad Hernandez	PR	Endocrinology, Diabetes & Metabolism Physician	$14.1K	$173.5K
Edwardo Ramos Cortes	PR	Physical Medicine & Rehabilitation Physician	$19.3K	$134.4K
Jorge Rivera-herrera	PR	Urology Physician	$62.6K	$0
Jaime Pinero-pares	PR	General Practice Physician	$41K	$0

San Jorge Children's Medical Specialties,psc — Billing Profile & Reimbursement Data

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San Jorge Children's Medical Specialties,psc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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