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.

Anestesia Del Norte P.s.c. (NPI 1114022431)

Key Findings

Field	Value
Entity Type	Organization
Organization	Anestesia Del Norte P.s.c.
Address	Urb Atenas Calle Hernandez Carrion #668
City	Manati
State	PR
ZIP	00674
Taxonomy	Specialist
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$5M
Medicare	$0

ANESTESIA DEL NORTE P.S.C. shows an effectively single-payer footprint: there is no Medicare billing on file while lifetime Medicaid revenue totals $5M, indicating the practice is heavily or exclusively dependent on Medicaid for billed services. Analysts should treat Medicaid as the material payer when evaluating this entity’s revenue trends and contract risk.

Revenue is highly concentrated in three procedure codes: 50590 accounts for $1.4M (28.6% of Medicaid revenue), 59515 accounts for $1.1M (21.2% of Medicaid revenue), and 47562 accounts for $500.5K (10.1% of Medicaid revenue); together these top three codes represent 59.9% of the provider’s total Medicaid revenue. This concentration suggests the business is materially exposed to demand or reimbursement changes for those specific service lines.

The top-revenue codes describe high-volume surgical and procedural care: 50590 (ESWL for kidney stones), 59515 (global cesarean delivery and postpartum care), and 47562 (laparoscopic cholecystectomy). Combined with the presence of procedure-monitoring codes (99155/99156/99157) and supply charges (99070), the code mix is consistent with operating primarily in hospital or procedural settings, providing intra-procedural monitoring/sedation and perioperative services.

State-level competitive standing is dominant for several core codes: the provider ranks #1 in-state for 50590, 59515, and 47562 (each labeled an "extreme outlier" and in the 100th percentile), indicating this entity is the leading in-state biller for ESWL, cesarean delivery global services, and laparoscopic cholecystectomy by a large margin. These rankings identify the provider as a major statewide source of those specific services and a key competitor for payers negotiating rates in those lines.

Beyond the top three, the practice reports very high volumes for several ancillary codes that support procedural care — for example, 99070 appears with 14.6K claims and $380.5K revenue (rank #4 of 225, 99th percentile, labeled "extreme outlier"), and 99222 has 6.5K claims and $370.2K revenue (rank #2 of 320, 100th percentile, labeled "extreme outlier"). These entries reinforce that much of the Medicaid revenue derives from procedure-related supplies and hospital inpatient evaluation/management services, not solely from a single CPT family.

Some procedure categories show more typical in-state participation: imaging supervision code 93458 ($81.9K, rank #11 of 36, 71st percentile) and primary delivery-only code 59514 ($78K, rank #4 of 12, 73rd percentile) fall into mid-range percentiles and should be interpreted as routine, non-dominant contributions to revenue rather than outlier concentrations. This mix suggests pockets of standard-volume services alongside the practice’s few dominant lines.

The presence of several anesthesia/monitoring codes (99155/99156/99157) and large claim counts for EKG services (93000: 13.5K claims, $228.7K revenue, rank #3 of 410, 100th percentile) indicates the provider performs or bills for procedural sedation/monitoring and peri-procedural diagnostics at scale. For payers, this pattern signals bundled episodes of care where monitoring, supply, and E/M services are meaningful contributors to total spend.

The provider’s NPI was enumerated on 2006-09-13 (~20 years ago), establishing a long tenure in the market; combined with the concentrated code dominance and high in-state rankings, this suggests an established operational presence and potentially entrenched referral or hospital relationships around those high-volume procedural services. Payers monitoring network adequacy or specialty capacity in the region should note both the longevity and the narrowly concentrated service mix when assessing contracting or utilization management strategies.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
50590	Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters.	2,640	$540	$1.4M
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.…	3,870	$270	$1.1M
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	1,790	$280	$500.5K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	14,630	$30	$380.5K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	6,500	$60	$370.2K
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…	13,450	$20	$228.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	4,560	$40	$191.6K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	2,110	$90	$187.3K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2,140	$50	$100.7K
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	370	$220	$81.9K

Showing 1–10 of 31

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

Anestesia Del Norte P.s.c. — 12 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93458	In this procedure, the provider performs imaging supervision and interpretation for a coronary angiography with left heart catheterization and intraprocedural injections for left ventriculography. He…	11	40	80	$680	$318.5K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	56	60	160	$380	$270.5K
50590	Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters.	1	20	120	$580	$193.3K
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.	84	110	270	$280	$148.1K
99156	A provider or other qualified healthcare professional, other than the provider performing a diagnostic or therapeutic procedure, administers medication to reduce consciousness, but not render the…	13	20	330	$120	$131.8K
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.…	1	30	100	$310	$109.3K
58558	The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples…	6	20	50	$590	$105.5K
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…	72	80	200	$250	$83.6K
99157	A provider or other qualified healthcare professional, other than the provider performing a diagnostic or therapeutic procedure, administers medication to reduce consciousness, but not render the…	7	20	300	$90	$77.4K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	4	230	410	$40	$51.9K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Pathology Csp	PR	Clinical Medical Laboratory	$0	$16.9M
Pci Group LLC	PR	Interventional Cardiology Physician	$0	$9.6M
Centro Cardiovascular De Manati Iii Csp	PR	Cardiovascular Disease Physician	$0	$5.7M
Mogic Ob-gyn Psc	PR	Obstetrics & Gynecology Physician	$0	$4.9M
Dorado Health Inc	PR	General Acute Care Hospital	$0	$3.7M
Dentistas Asociados Del Norte	PR	General Practice Dentistry	$0	$3M
Crilomil Corp.	PR	Pediatric Dentistry	$0	$2.8M
Hospitalist Medical Services, Psc	PR	Anesthesiology Physician	$0	$2.7M
Atlantic Pathology	PR	Clinical Medical Laboratory	$0	$2.5M
Centro Imagenes Manati Yvf Psc	PR	Diagnostic Radiology Physician	$0	$2.3M

Anestesia Del Norte P.s.c. — Billing Profile & Reimbursement Data

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Anestesia Del Norte P.s.c. — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References