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.

Lubilu Therapy Group, LLC (NPI 1083044671)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lubilu Therapy Group, LLC
Address	4601 Calle Miguel Pou
City	Ponce
State	PR
ZIP	00728
Taxonomy	Speech-Language Pathologist
NPI Enumerated	November 18, 2013

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

This provider has no Medicare billing on file and is effectively single‑payer in the available data: total Medicaid revenue is $9.2M with no Medicare revenue reported. Analysts should treat Medicaid as the dominant and only recorded public payer for this entity.

Revenue is highly concentrated in three procedure codes: the precomputed top 3 Medicaid codes by revenue account for 91.8% of this provider's total Medicaid revenue. In particular, 92507 represents $6.5M (70.8% of Medicaid revenue), 97112 represents $1M (10.9%), and 97110 represents $923.3K (10.0%), signaling a narrow set of revenue drivers.

The code mix and descriptions indicate the operation is driven by high-volume, direct therapy encounters: 92507 (individual speech–language therapy) dominates the book of business, while 97112 (neuromuscular reeducation) and 97110 (therapeutic exercise) point to substantial rehabilitative therapy activity alongside speech services. This pattern suggests a clinic model focused on frequent one‑on‑one treatment sessions rather than episodic or procedure-heavy care.

Competitive standing within Puerto Rico is extreme for the top codes: 92507 ranks #3 of 141 providers in-state (99th percentile; extreme outlier), 97112 ranks #1 of 74 providers in-state (100th percentile; extreme outlier), and 97110 ranks #2 of 182 providers in-state (99th percentile; extreme outlier). These ranks indicate the provider is a dominant statewide participant for those services and operates well above typical state volume for the same codes.

Operational volume metrics confirm very high throughput: 92507 shows 130.3K claims at $50 avg paid/claim, 97112 shows 40.3K claims at $25 avg paid/claim, and 97110 shows 42K claims at $22 avg paid/claim. The large claim counts combined with modest average payments per claim are consistent with a high‑frequency therapy delivery model.

Although the top three codes account for the vast majority of revenue, the provider also bills a range of smaller services—e.g., 97530 ($345.6K, 3.8%), 92523 ($141K, 1.5%), G0515 ($131.7K, 1.4%), and 97533 ($111.2K, 1.2%)—indicating some breadth in functional, cognitive, and sensory therapy offerings that together make up a modest share of revenue. These ancillary codes suggest capability to serve related therapy needs even though they are not primary revenue drivers.

The provider has an established NPI (enumerated 2013-11-18, ~13 years ago), and sustained Medicaid receipts of $9.2M are consistent with a mature, high-volume outpatient therapy operation. Tenure plus the concentrated revenue profile supports classification as an established specialty therapy practice within the state.

Because the provider is an extreme outlier on multiple high‑revenue Medicaid codes and shows heavy revenue concentration in 92507, 97112, and 97110, analysts should prioritize peer-pattern benchmarking and utilization review for these codes when assessing network strategy or payment risk. Focused reviews on service mix, session frequency, and claim-level documentation for these specific codes will be most informative.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	130,310	$50	$6.5M
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	40,270	$30	$1M
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	41,970	$20	$923.3K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	8,860	$40	$345.6K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	1,080	$130	$141K
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	7,320	$20	$131.7K
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	5,300	$20	$111.2K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	250	$60	$15.5K
97127	N/A	320	$20	$5K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	260	$20	$4.2K

Showing 1–10 of 11

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

Lubilu Therapy Group, LLC — 3 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97533	In this procedure, the provider uses sensory integrative techniques in patients with established dysfunction of sensory processing, for example, children with autism, and brain injuries. This service…	15	50	1,850	$70	$843.5K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	3	140	2,620	$50	$505.7K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	5	40	1,150	$40	$135.4K
G0515	Development of cognitive skills to improve attention, memory, problem solving (includes compensatory training), direct (one-on-one) patient contact, each 15 minutes	3	10	770	$20	$110.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	2	180	2,150	$20	$95.2K
97129	The provider works directly one–on–one with the patient to help him improve cognitive functions such as thinking, remembering, reasoning, and problem solving and the ability to plan, organize, and…	11	10	1,040	$20	$60.6K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	1	70	950	$20	$60.4K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	5	40	40	$100	$46.6K
97166	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of moderate analytic complexity, which includes analysis of occupational profile, problem–focused assessment…	3	10	50	$50	$16.5K
97127	N/A	2	10	290	$1	$2.3K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alivia Infusion Services LLC	PR	Home Infusion Therapy Pharmacy	$0	$10.9M
Laboratorio La Providencia De Ponce	PR	Clinical Medical Laboratory	$16.4K	$1.7M
Sheila Colon Villarrubia	PR	Public Health & General Preventive Medicine Physician	$0	$1.2M
S & R Laboratorio Clinico Corp	PR	Clinical Medical Laboratory	$1.7K	$846.2K
Miguel Echevarria Rodriguez	PR	Diagnostic Radiology Physician	$0	$820.6K
Sergio Collazo Sr	PR	Land Ambulance	$12.8K	$753.9K
Laboratorio Clinico El Tuque, Inc	PR	Clinical Medical Laboratory	$1.4K	$696.7K
Jesus Rodriguez Rodriguez	PR	General Practice Physician	$6.6K	$224.2K
Walgreen Co	PR	Pharmacy	$60.7K	$0
Luis Rodriguez Hernandez	PR	Internal Medicine Physician	$14.9K	$8.3K

Lubilu Therapy Group, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References