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NPI 1063577385 · San Juan, PR · Nephrology Physician
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Francisco Torre is a nephrology physician provider located in San Juan, Puerto Rico. This profile covers 13 Medicare and 6 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Francisco Torre |
| Address | Paseo Del Prado |
| City | San Juan |
| State | PR |
| ZIP | 00926 |
| Taxonomy | Nephrology Physician |
| NPI Enumerated | December 27, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $111.2K |
| Medicaid | $4.3K |
FRANCISCO TORRE is a nephrology physician with a long Medicare/NPI tenure, enumerated since 2006-12-27 (~20 years ago), indicating sustained presence in the Medicare program and likely established referral relationships in SAN JUAN, PR. This length of enrollment supports interpretation of observed billing patterns as the result of a steady clinical practice rather than a recent entrant.
Medicare revenue dominates this profile: lifetime Medicare revenue is $111.2K versus Medicaid revenue of $4.3K, so the provider operates at effectively single-payer scale with Medicare driving the vast majority of billed dollars. Analysts should treat Medicaid activity as minimal relative to Medicare when assessing volume and service-line economics.
Revenue concentration on Medicare is notable: the precomputed top 3 Medicare codes account for 65.2% of this provider's total Medicare revenue, signaling dependence on a small set of renal-related services for most Medicare dollars. Clinically, those top revenue drivers include ESRD monthly management (90960 and 90961) and a vascular/radiologic dialysis access procedure (36902), which together suggest a practice focused on dialysis patient management and interventional access care.
Medicaid revenue shows even greater concentration: the precomputed top 3 Medicaid codes account for 99.6% of total Medicaid revenue, with 90960 alone representing 56.8% and 99214 another 38.6%. This indicates Medicaid billing is almost entirely for monthly ESRD management and outpatient E/M visits, mirroring the Medicare service mix but at much lower dollar scale.
Competitive standing for key Medicare codes is mixed and generally modest. For the highest Medicare revenue code 90960 the provider ranks #3796 of 6549 (42nd percentile), characterized as typical, unremarkable volume nationally; 99214 sits at the 75th percentile (#117234 of 479517) which is relatively stronger among peers for E/M office visit volume; by contrast 36902 ranks near the bottom of its specialty peer list (#1507 of 1666, 5th percentile) indicating very limited activity in angioplasty of dialysis access compared with national interventional providers. Overall, the provider is not a dominant national player in dialysis access interventions but shows reasonable E/M outpatient volume.
State-level competitive standing on Medicaid indicates very low relative volume for the ESRD monthly code: 90960 ranks #39 of 39 in-state (0th percentile), so this provider is on the low end among Puerto Rico peers for that Medicaid code despite it accounting for a majority of their Medicaid revenue. Similarly, 99214 ranks in the 17th percentile in-state for Medicaid, so outpatient E/M Medicaid activity is modest compared with local peers. These ranks suggest limited Medicaid market share.
Service-line implications from the code mix point to an operational focus on chronic dialysis care management and related acute inpatient and vascular access procedures: high-revenue Medicare codes include ESRD monthly management (90960/90961), hospital inpatient E/M (99232/99223/99233), and tunneled catheter replacement (36581). The presence of both outpatient E/M (99214) and inpatient/subsequent visit codes indicates the provider covers both ambulatory and hospital-based nephrology care for dialysis patients, likely pairing longitudinal ESRD management with episodic access procedures.
There are a few statistical signals worth noting: several commonly billed codes are described as "typical, unremarkable volume" at their reported percentiles (e.g., 90960 at 42nd, 90961 at 45th, 90935 at 44th), which indicates the provider operates at expected volumes for a nephrology practice rather than exhibiting unusually high or low Medicare billing patterns. However, the low national percentile for 36902 (5th percentile) and the bottom in-state ranking for Medicaid 90960 (0th percentile) are outliers toward low volume in those procedure-specific buckets, suggesting limited local and national market share for interventional dialysis access procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 90960 | The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the… | 130 | $270 | $35.8K |
| 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… | 260 | $90 | $23.8K |
| 36902 | The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize… | 10 | $990 | $12.9K |
| 90961 | The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the… | 40 | $230 | $9.4K |
| 36581 | This procedure is a complete replacement of a tunneled CVA catheter in cases of blockage, damage, or malfunction. | 10 | $580 | $8.2K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 120 | $60 | $7.6K |
| 99223 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 30 | $140 | $4.5K |
| 90935 | Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally… | 60 | $60 | $3.1K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 20 | $90 | $2.2K |
| 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… | 10 | $110 | $1.6K |
Showing 1–10 of 13
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
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 90960 | The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the… | 10 | $210 | $2.5K |
| 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… | 40 | $40 | $1.7K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 180 | $1 | $180 |
| 99153 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, beyond the 15 minutes of intraservice… | 20 | $1 | $20 |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 20 | $0 | $0 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 200 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
6 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 90960 | The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the… | 39 | 40 | 350 | $180 | $140.4K |
| 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… | 743 | 900 | 360 | $30 | $42.5K |
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 11 | 20 | 180 | $50 | $23.6K |
| 99152 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, in a patient five years of age or… | 14 | 20 | 60 | $20 | $5.4K |
| 99153 | The provider performing a diagnostic or therapeutic procedure administers medication to reduce consciousness, but not render the patient unconscious or asleep, beyond the 15 minutes of intraservice… | 9 | 10 | 140 | $10 | $1.7K |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 15 | 30 | 150 | $0 | $0 |
Other providers in the same ZIP code as Francisco Torre, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Farmacia Doral, Inc. | PR | Specialty Pharmacy | $0 | $115.6M |
| Grupo Neonatal C.s.p. | PR | Neonatal-Perinatal Medicine Physician | $0 | $6M |
| Aps Clinics Of Puerto Rico, Inc. | PR | Adult Mental Health Clinic/Center | $0 | $5.7M |
| Alejandro Marmolejo | PR | General Practice Physician | $2.5K | $2.1M |
| Bvr Ambulance Best Care Inc | PR | Land Ambulance | $10.2K | $1.6M |
| Jan Rodriguez Ferrer | PR | Internal Medicine Physician | $60.6K | $1.4M |
| Nuvasive Pr, Inc. | PR | Durable Medical Equipment & Medical Supplies | $0 | $1.2M |
| Rebeca Cuebas | PR | Pediatrics Physician | $0 | $1M |
| Cck Medical Csp | PR | Cardiovascular Disease Physician | $0 | $983K |
| Renato Rivera | PR | Family Medicine Physician | $0 | $886.7K |
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