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.

Southwest Health Corp. (NPI 1063435782)

Southwest Health Corp. is a general acute care hospital provider located in San German, Puerto Rico. This profile covers 0 Medicare and 48 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	Southwest Health Corp.
Address	8 Calle Javilla
City	San German
State	PR
ZIP	00683
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 25, 2006

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	4,330	$150	$658.2K
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.	3,700	$90	$314.5K
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.	1,960	$150	$301.5K
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…	2,170	$40	$84.7K
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…	10,090	$10	$70.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	5,520	$10	$49.7K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	990	$40	$36.6K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	1,300	$30	$32.5K
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…	2,440	$10	$24.4K
72100	The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…	2,360	$10	$23.6K

Showing 1–10 of 48

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

Southwest Health Corp. — 0 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

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	19	80	900	$110	$242K
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.	18	70	730	$110	$178.7K
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…	55	150	1,180	$70	$170.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	74	110	270	$280	$148.1K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	108	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.	18	80	1,150	$50	$125.5K
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…	80	130	480	$90	$109.4K
59515	In this global service, the provider provides admission to the hospital for cesarean delivery of the fetus and placenta via an abdominal incision, and inpatient and outpatient postpartum care.…	33	30	100	$310	$109.3K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	41	80	200	$250	$83.6K
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.	420	500	220	$40	$79.5K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centro Cardiovascular De San German,csp	PR	Cardiovascular Disease Physician	$0	$4.6M
David Silva Caraballo	PR	Ophthalmology Physician	$6.8K	$4M
Hospital De La Concepcion Inc	PR	General Acute Care Hospital	$0	$3.8M
Western Hematology Oncology Group P.s.c	PR	Specialist	$0	$1.8M
Laboratorio Clinico Sangermeno Principal	PR	Clinical Medical Laboratory	$4.8K	$1.3M
San German X Ray & Body Imaging Center, Psc.	PR	Specialist	$0	$1.2M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$0	$1M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$0	$800.8K
Axel Baez-torres	PR	Anatomic Pathology & Clinical Pathology Physician	$6.3K	$738.4K
Jorge Ramirez De Arellano	PR	Public Health Dentistry	$0	$626.5K

Southwest Health Corp. — 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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