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.

Inspira Behavioral Care Corp. (NPI 1063928596)

Inspira Behavioral Care Corp. is a adult mental health clinic/center provider located in Cidra, 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	Inspira Behavioral Care Corp.
Address	12 Calle Roman Baldorioty De Castro
City	Cidra
State	PR
ZIP	00739
Taxonomy	Adult Mental Health Clinic/Center
NPI Enumerated	December 20, 2017

Payer Source	Total Paid
Medicaid	$712K
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
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	9,420	$30	$282.4K
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…	5,670	$40	$204.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	5,010	$30	$160.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	880	$30	$30K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	2,040	$10	$24.5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	170	$50	$8.9K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	30	$30	$810
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	30	$20	$550
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	30	$10	$330
98967	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	180	$0	$0

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

Inspira Behavioral Care Corp. — 0 of 9 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
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…	323	3,230	330	$10	$42.4K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	20	30	150	$10	$24.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	33	320	470	$10	$20K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	66	840	340	$1	$16.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	45	90	170	$10	$15.1K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	5	40	210	$10	$14.3K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	252	290	270	$10	$10.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	276	320	210	$20	$10K
99442	N/A	291	450	130	$10	$9K
99441	N/A	208	480	400	$1	$7.8K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cossma Inc	PR	Primary Care Clinic/Center	$0	$3M
Cyrcorp	PR	Radiologic Technologist	$0	$1.7M
Cidra Medical Labs Inc	PR	Clinical Medical Laboratory	$1.3K	$1.6M
Clinica Cardiovascular Md C S P	PR	Cardiovascular Disease Physician	$0	$1.2M
Jocelyn Montalvo Ortiz	PR	Neurology with Special Qualifications in Child Neurology Physician	$0	$1.1M
Andral St. Fleur	PR	General Practice Physician	$0	$871.3K
Centro De Terapia Fisica Y Clinica Del Dolor, Csp	PR	Physical Therapist	$0	$758.8K
Christian Hernandez Cuevas	PR	General Practice Physician	$0	$682.5K
Hablemos Centro De Habilitacion Y Rehabilitacion Del Habla-lenguajecrl	PR	Speech-Language Pathologist	$0	$680.4K
Laboratory Medicine Services Incorporated	PR	Clinical Medical Laboratory	$3.2K	$616.6K

Inspira Behavioral Care Corp. — Billing Profile & Reimbursement Data

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Inspira Behavioral Care 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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References