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.

Advanced Ob-gyn Psc (NPI 1144316803)

Advanced Ob-gyn Psc is a obstetrics & gynecology physician provider located in Cayey, Puerto Rico. This profile covers 0 Medicare and 17 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	Advanced Ob-gyn Psc
Address	Carr 14 Interior Km 0.3
City	Cayey
State	PR
ZIP	00736
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	October 4, 2006

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	440	$1,590	$702.8K
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…	8,620	$60	$500.1K
59510	In this global service, the provider provides all of the antepartum care, admission to the hospital for delivery, delivery of the fetus and placenta via an abdominal incision, and inpatient and…	130	$1,730	$231.2K
76827	The provider performs a complete fetal Doppler echocardiography by pulsed or continuous sound waves with spectral display to assess blood flow in the fetus.	2,570	$50	$138.5K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	3,410	$40	$136.4K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	860	$110	$91.9K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	1,260	$70	$85.7K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	2,200	$20	$39.5K
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,…	1,540	$20	$30.8K
99203	The provider sees a new 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 provider…	250	$90	$21.3K

Showing 1–10 of 17

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

Advanced Ob-gyn Psc — 3 of 17 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

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	1	10	80	$1,450	$151.2K
59510	In this global service, the provider provides all of the antepartum care, admission to the hospital for delivery, delivery of the fetus and placenta via an abdominal incision, and inpatient and…	2	10	20	$1,570	$131.7K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	24	30	210	$60	$53.9K
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,…	92	230	410	$40	$51.9K
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…	229	3,230	330	$10	$42.4K
99203	The provider sees a new 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 provider…	555	1,400	160	$50	$29.6K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	20	120	130	$60	$26.9K
76827	The provider performs a complete fetal Doppler echocardiography by pulsed or continuous sound waves with spectral display to assess blood flow in the fetus.	1	10	50	$50	$22.6K
99281	The provider sees a patient for the lowest level emergency department visit.	52	90	80	$10	$21.5K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	1	90	170	$30	$18K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Agosto Allergy And Immunology Csp	PR	Allergy & Immunology Physician	$0	$2.4M
Laboratorio Clinico Montellano Inc	PR	Clinical Medical Laboratory	$16.3K	$1.8M
Juan Benitez Santana	PR	General Practice Physician	$3.6K	$1.3M
Anestesia Del Caribe,csp	PR	Anesthesiology Physician	$0	$1.2M
Luis Suarez Almedina	PR	Pediatrics Physician	$0	$1.1M
Luis Garcia - Lopez	PR	Physical Medicine & Rehabilitation Physician	$0	$1M
Gobierno Municipal De Cayey	PR	Clinic/Center	$0	$1M
Centro Fisiatrico Del Plata Psc	PR	Physical Medicine & Rehabilitation Physician	$0	$994.3K
Jam Ambulance Service Inc	PR	Land Ambulance	$17.6K	$962.3K
Gonzalez Lopez Inc	PR	Clinical Medical Laboratory	$1.6K	$844.9K

Advanced Ob-gyn Psc — Billing Profile & Reimbursement Data

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Advanced Ob-gyn Psc — 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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