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.

Luis Ortiz-espinosa (NPI 1053390732)

Field	Value
Entity Type	Individual
Organization	Luis Ortiz-espinosa
Address	Pq-28 Ave. El Comandante
City	Carolina
State	PR
ZIP	00983
Taxonomy	Dermatology Physician
NPI Enumerated	January 11, 2006

Payer Source	Total Paid
Medicare	$183.3K
Medicaid	$0

Key Findings

This provider's Medicare revenue is highly concentrated: the precomputed top 3 Medicare codes (17108, 17004, 99213) account for 76.1% of lifetime Medicare revenue, with 17108 contributing $76.1K (41.5%), 17004 contributing $42.8K (23.3%), and 99213 contributing $20.6K (11.3%). Claim volumes for those codes are 156, 327, and 333 respectively, which together drive the bulk of the reported $183.3K in Medicare receipts.

The code mix indicates a procedurally focused dermatology practice centered on lesion destruction and office-based procedures: 17108 (cutaneous vascular destruction by laser), 17004 (destruction of 15+ premalignant lesions), and 17111 (destruction of 15+ benign lesions) are dominant procedural codes, while biopsies (11102, 11103), excisions/extractions (10040), and intralesional injections (11901) appear regularly. The presence of 99213 as a top revenue code shows routine established-patient evaluation and management accompanies these procedures rather than heavy reliance on high-complexity consults.

Certain procedure codes stand out relative to national peers: 17004 ranks #359 of 9638 providers (96th percentile) and is labeled "notably above typical national volume," and 10040 ranks #27 of 962 providers (97th percentile) and is also described as "notably above typical national volume." These labels and percentiles signal this provider performs premalignant-lesion destruction and lesion extractions at unusually high volumes compared with national dermatology peers.

Other high-revenue codes show more typical participation: 17108 (rank #14 of 35, 62th percentile) and 99213 (rank #51516 of 457151, 89th percentile) are both characterized as "typical, unremarkable volume," indicating the provider's laser vascular treatments and routine E/M visits are within expected national ranges rather than being outlier practices. This mix suggests the practice is neither a national center of volume for vascular laser work nor a low-volume outlier overall, but occupies a middle ground for those services.

Payer mix is effectively single-payer in the available data: lifetime Medicare revenue is $183.3K and there is "none below" for Medicaid billing on file, so Medicaid contributes no recorded revenue. That absence of Medicaid activity means the provider's public-payer exposure is concentrated entirely in Medicare and any Medicaid-related strategy or risk is not visible in these claims.

The provider has an established NPI tenure (NPI enumerated 2006-01-11 (~20 years ago)) but a modest reported Medicare scale: $183.3K in lifetime Medicare receipts over roughly two decades suggests a small Medicare panel, limited Medicare utilization, or a practice that primarily serves commercial/non-Medicare patients not visible in this dataset. This tenure-plus-scale profile is consistent with a stable, narrow-scope dermatology practice rather than a large, Medicare-focused group.

Examination of lower-revenue but high-count codes indicates procedural throughput of many low-dollar units: 17003 shows 240 claims but only $1.2K revenue and 11901 has 177 claims for $5.5K revenue. These patterns reflect frequent, short procedures (add-on lesion destructions and intralesional injections) that generate volume-based activity without large per-claim reimbursement, reinforcing a high-frequency procedural business model.

Case-mix implications show a focus on established-patient procedural care rather than complex new consults: only 26 claims for 99203 (new patient E/M) versus 333 claims for 99213 (established patient E/M) and substantial counts for destruction/biopsy codes. This suggests the provider's practice is oriented toward treatment and maintenance of skin conditions for returning patients rather than serving as a high-volume new-patient referral center.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
17108	Cutaneous vascular destruction is generally performed with a laser (e.g. Argon, pulsed dye, and YAG). This is a bloodless surgery due to the fact that there is no incision made in the skin. This…	160	$490	$76.1K
17004	The provider destroys 15 or more premalignant lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others.	330	$130	$42.8K
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…	330	$60	$20.6K
17111	The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of 15 lesions or more, other than skin tags or…	140	$80	$11.3K
17107	Cutaneous vascular destruction is generally performed with a laser (e.g. Argon, pulsed dye, and YAG). This is a bloodless surgery due to the fact that there is no incision made in the skin. This…	20	$360	$7.8K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	150	$50	$7K
10040	The provider performs extractions to treat skin lesions such as milia, comedones, cysts, or pustules. The procedure may involve surgically opening the lesion, draining it, or removing it entirely.	120	$60	$6.5K
11901	This code describes an intralesional injection of a corticosteroid, such as triamcinolone acetonide, for treatment of large nodules, keloids, lichenified hyperkeratotic lesions, and numerous other…	180	$30	$5.5K
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…	30	$70	$1.8K
11103	The provider biopsies an additional skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette. Report +11103 for each separate lesion…	30	$40	$1.2K

Showing 1–10 of 13

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Luis Ortiz-espinosa — 7 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. state median

13 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
17108	1	10	110	$480	$54.3K
17004	1	10	50	$130	$12K
17107	1	10	20	$350	$7.8K
17111	1	10	60	$80	$5K
99213	14	1,530	50	$60	$4.2K
11901	1	10	120	$30	$4.1K
11102	3	50	30	$70	$3.1K
17000	14	30	30	$40	$2.6K
10040	1	10	20	$60	$2.4K
11103	5	10	30	$40	$2.4K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Luis Ortiz-espinosa, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Juan Flores-gonzalez	PR	Pulmonary Disease Physician	$8.5K	$638.5K
Eneida De La Torre - Lugo	PR	Dermatology Physician	$7.5K	$179K
Roberto Vendrell	PR	Gastroenterology Physician	$20.9K	$53.1K
Abdiel Cruz-loubriel	PR	Gastroenterology Physician	$14.2K	$42.8K
Lymarie Aguila Gonzalez	PR	Dermatology Physician	$15.2K	$9.2K
Fernando Sepulveda-irizarry	PR	Physical Medicine & Rehabilitation Physician	$6K	$0

Nearby Providers

Other providers in the same ZIP code as Luis Ortiz-espinosa, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coreplus Servicios Clinicos Y Patologicos LLC	PR	Anatomic Pathology & Clinical Pathology Physician	$110.9K	$13M
Jose Lozada	PR	Gynecology Physician	$1.2K	$777.8K
Monserrate Imaging Center Psc	PR	Body Imaging Physician	$0	$753.9K
Elena Nogales Perez	PR	Dermatology Physician	$15.7K	$93.7K
Walgreen Co	PR	Pharmacy	$99.2K	$0
Lynette Rios Rodriguez	PR	Physical Therapist	$29.9K	$46.8K
Ricardo Jaen	PR	Podiatrist	$11.6K	$25.7K
Walgreen Co	PR	Pharmacy	$34.4K	$0
Signet Puerto Rico	PR	Nuclear Medicine Physician	$18K	$10.7K
Cesar Gomez	PR	Physical Medicine & Rehabilitation Physician	$27K	$0

Luis Ortiz-espinosa — Billing Profile & Reimbursement Data

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Luis Ortiz-espinosa — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References