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.

Ortho & Surgical Solutions, Inc (NPI 1114256815)

Field	Value
Entity Type	Organization
Organization	Ortho & Surgical Solutions, Inc
Address	Amelia Ind Park
City	Guaynabo
State	PR
ZIP	00968
Taxonomy	Prosthetic/Orthotic Supplier
NPI Enumerated	December 9, 2009

Payer Source	Total Paid
Medicaid	$7.8M
Medicare	$0

Key Findings

This entity is registered as a Prosthetic/Orthotic Supplier and its Medicaid billing profile is dominated by prosthetic device claims: L8699 (Prosthetic implant, not otherwise specified) accounts for the entire reported Medicaid revenue, which is $7.8M. The code-level detail (L8699) and the provider taxonomy together indicate operations focused on supplying or fitting high-cost prosthetic implants rather than a broad mix of clinical services.

Revenue concentration is extreme on the Medicaid side: the precomputed top-3 share for Medicaid equals 100.0%, and the single listed code L8699 alone represents $7.8M in revenue. This means the provider’s Medicaid portfolio is effectively single-code dependent, creating operational exposure to reimbursement changes or policy updates tied to that code.

Claim volume and unit economics for L8699 are concentrated and high-cost: the record shows 3.3K claims with a $2340 avg paid/claim. Those figures imply the provider’s Medicaid revenue base is driven by a relatively large number of mid-to-high-dollar prosthetic payments rather than many low-cost services.

Competitive standing within the state is modest: L8699 ranks #6 of 23 providers in-state (77th percentile; typical, unremarkable volume for this code). Being in the 77th percentile suggests the provider has above-median activity for this code among peers but is not a dominant statewide supplier.

Payer mix is effectively single-payer: there is no Medicare billing on file (none below for Medicare), while Medicaid shows $7.8M in lifetime revenue. Analysts should treat this entity as Medicaid-dependent for the available claims history and not rely on Medicare-based comparisons for revenue or utilization benchmarks.

Tenure is long-established: the provider’s NPI was enumerated on 2009-12-09 (~17 years ago), indicating more than a decade of enrollment during which it developed its Medicaid prosthetics business. This length of enrollment supports that the concentrated billing pattern is persistent rather than the result of a very recent enrollment spike.

Given the data labels and percentile language tied to L8699 ('typical, unremarkable volume'), the provider’s utilization for this code does not appear to be a statistical outlier in-state. The combination of a single dominant code and an above-median rank frames the provider as a specialized, steady regional participant in prosthetic implant supply rather than an anomalous or unusually high-volume outlier.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
L8699	Prosthetic implant, not otherwise specified	3,310	$2,340	$7.8M

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

Ortho & Surgical Solutions, Inc — 0 of 1 code 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

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
L8699	Prosthetic implant, not otherwise specified	6	20	740	$2,660	$4.6M

Nearby Providers

Other providers in the same ZIP code as Ortho & Surgical Solutions, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alivia Specialty, LLC	PR	Specialty Pharmacy	$0	$189M
Medtronic Puerto Rico Operations	PR	Durable Medical Equipment & Medical Supplies	$0	$19.7M
Cuerpo De Emergencias Medicas De	PR	Land Ambulance	$108.2K	$9.4M
Santa Merle	PR	Hematology & Oncology Physician	$4.5K	$2M
Bard Shannon Limited	PR	Prosthetic/Orthotic Supplier	$0	$1.2M
Guaynabo Ambulatory Surgical Group, Inc	PR	Ambulatory Surgical Clinic/Center	$275K	$53.4K
Ricardo Hernandez-castillo	PR	Pulmonary Disease Physician	$28.6K	$211.9K
Maria De Aranzazu Villamil Jarauta	PR	Endocrinology, Diabetes & Metabolism Physician	$42.3K	$151.8K
Juan Malpica-santiago	PR	Pulmonary Disease Physician	$33.2K	$148.3K
Fernando Zalduondo	PR	Diagnostic Radiology Physician	$125.9K	$0

Ortho & Surgical Solutions, Inc — Billing Profile & Reimbursement Data

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Ortho & Surgical Solutions, Inc — 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