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.

Juan Fernandez Fernandez (NPI 1124467394)

Field	Value
Entity Type	Individual
Organization	Juan Fernandez Fernandez
Address	Ave. 65 De Infanteria, Carr. 3, Km 8.3
City	Carolina
State	PR
ZIP	00985
Taxonomy	Emergency Medicine Physician
NPI Enumerated	June 20, 2013

Payer Source	Total Paid
Medicare	$82.4K
Medicaid	$0

Key Findings

JUAN FERNANDEZ FERNANDEZ is an Emergency Medicine physician with an NPI enumerated on 2013-06-20 (~13 years ago). His lifetime Medicare revenue is $82.4K and there is no Medicaid billing on file, so this profile represents an effectively single-payer (Medicare-only) billing footprint at a modest revenue scale.

Revenue is highly concentrated: the precomputed top 3 Medicare codes by revenue account for 95.5% of this provider's total Medicare revenue. Those three codes are 99285 (52.5%), 99291 (35.6%), and 99284 (7.5%), indicating nearly all Medicare dollars flow from high-acuity ED and critical care visit codes.

The code mix and counts point to an emergency-department and critical-care operating focus. The provider billed 99285 306 times (average paid $141/claim) generating $43.1K, and billed 99291 173 times (average paid $169/claim) generating $29.2K, which together form the bulk of clinical activity and revenue.

Competitive standing on key codes is above many peers nationally but not an extreme outlier: 99285 ranks #5938 of 61347 providers nationally (90th percentile) and 99291 ranks #6420 of 71290 providers nationally (91th percentile), with both described as "typical, unremarkable volume for this code." This suggests the provider reports higher-than-median volume on those high-acuity codes while still fitting within common national patterns rather than representing an outlier.

Lower-revenue add-ons and ancillary services are present but minor contributors to Medicare revenue. For example, 99292 (add-on critical care) appears 27 times for $2.3K (2.9% of Medicare revenue) and 93010 (ECG interpretation) appears 223 times for $1.3K (1.6% of Medicare revenue), indicating routine use of ancillary critical-care and diagnostic services with limited revenue impact.

The absence of any Medicaid claims ("none below") means there is no state Medicaid footprint to compare, making payer-mix risk concentrated in Medicare. With $82.4K of lifetime Medicare revenue and no Medicaid billing, the provider’s public-payer exposure is concentrated and any Medicare reimbursement or policy change would disproportionately affect this billing base.

Operationally, the very high share of revenue from a small set of high-acuity ED/critical-care codes implies revenue sensitivity to shifts in emergency-department volumes, critical-care assignment, or documentation practices tied to those codes. Because the top three codes drive the practice economically, small changes in utilization or coding of 99285, 99291, or 99284 could materially alter overall receipts.

Although the provider ranks in higher national percentiles for key ED and critical-care codes, the overall lifetime Medicare revenue level and claim counts are consistent with a modest, non-enterprise practice footprint rather than a large-volume ED group. The combination of ~13 years of enumeration with a concentrated, Medicare-only revenue profile is consistent with a stable but limited Medicare-facing emergency medicine practice or shift-based role rather than a high-volume independent billing entity.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	310	$140	$43.1K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	170	$170	$29.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	60	$100	$6.1K
99292	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	30	$90	$2.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	220	$10	$1.3K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Juan Fernandez Fernandez — 3 of 5 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. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	3	70	100	$140	$16.4K
99291	2	70	40	$170	$9K
99284	36	130	40	$90	$4.7K
99292	1	10	30	$90	$2.4K
93010	2	160	20	$10	$240

Related Providers

Other providers that share a Tax Identification Number (TIN) with Juan Fernandez Fernandez, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Florida Emergency Physicians Kang And Associates Md LLC	FL	Emergency Medical Services (Emergency Medicine) Physician	$0	$58.5M
Esteban Lugo-ramos	PR	Emergency Medicine Physician	$34.8K	$0
Kimberly Feliberti Ramos	PR	Emergency Medicine Physician	$34.6K	$0
Timothy Hirsch	FL	Physician Assistant	$31.3K	$0
Trace Dotson	MI	Emergency Medical Services (Emergency Medicine) Physician	$29.8K	$0
Leslie Camacho Acevedo	PR	Emergency Medicine Physician	$17.1K	$0

Nearby Providers

Other providers in the same ZIP code as Juan Fernandez Fernandez, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Instituto De Ojos Y Piel, Inc	PR	Optometrist	$0	$3.2M
Clinical Medical Services Inc	PR	Durable Medical Equipment & Medical Supplies	$0	$2.4M
Health Laboratories Services Inc	PR	Clinical Medical Laboratory	$28.3K	$2.3M
Ada Colon-gavillan	PR	Physical Therapy Clinic/Center	$0	$1.4M
Pedro Rivera Caballero	PR	General Practice Physician	$3.1K	$1.3M
Rivera-revilla Lab LLC	PR	Clinical Medical Laboratory	$4K	$1.3M
Centro Radiodiagnostico Carolina	PR	Diagnostic Radiology Physician	$0	$1.2M
Family Medicine Group Inc.	PR	Adult Medicine Physician	$0	$1.1M
Juan Ledoux	PR	General Practice Dentistry	$0	$968K
Milab LLC	PR	Clinical Medical Laboratory	$1.9K	$889.3K

Juan Fernandez Fernandez — Billing Profile & Reimbursement Data

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Juan Fernandez Fernandez — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References