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.

Jose J Lopez Agudo Oftalmologo Csp (NPI 1144422858)

Field	Value
Entity Type	Organization
Organization	Jose J Lopez Agudo Oftalmologo Csp
Address	5z30 Calle 5-20
City	Fajardo
State	PR
ZIP	00738
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 4, 2007

Payer Source	Total Paid
Medicaid	$763.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	5,250	$70	$356.7K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	1,740	$110	$197.1K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	4,500	$30	$153K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	540	$90	$49.7K
92020	The provider examines the angle of the anterior chamber of the eye (the angle where the iris and cornea meet) using a special lens (goniolens) and slit–lamp or operating microscope to diagnose and…	860	$1	$2.6K
92201	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	310	$10	$1.9K
92226	N/A	1,520	$1	$1.5K
76514	The provider uses conventional contact B scan imaging to measure the thickness of the cornea in one or both eyes.	1,060	$1	$1.1K
2021F	No Summary found for this code	550	$0	$0
2022F	The ophthalmology or optometry provider performs a dilated retinal eye exam in a diabetic patient with evidence of diabetic retinopathy. He interprets the findings and documents them in the patient’s…	590	$0	$0

Showing 1–10 of 15

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

Jose J Lopez Agudo Oftalmologo Csp — 2 of 8 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	31	350	540	$50	$96.4K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	36	120	180	$80	$62.9K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	40	530	630	$20	$32K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	4	200	120	$80	$30.5K
92202	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	23	90	450	$10	$17.8K
92201	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	33	80	200	$20	$15.1K
92226	N/A	25	80	740	$10	$9.5K
92225	N/A	64	120	280	$10	$7.8K
92020	The provider examines the angle of the anterior chamber of the eye (the angle where the iris and cornea meet) using a special lens (goniolens) and slit–lamp or operating microscope to diagnose and…	14	50	190	$10	$7.1K
76514	The provider uses conventional contact B scan imaging to measure the thickness of the cornea in one or both eyes.	1	50	130	$1	$910

Showing 1–10 of 15

Nearby Providers

Other providers in the same ZIP code as Jose J Lopez Agudo Oftalmologo Csp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Y De Ref De Fajardo Inc	PR	Clinical Medical Laboratory	$26.2K	$2.8M
Servicios Medicos Integrados De Fajardo, P.s.c.	PR	General Practice Physician	$0	$2.8M
Centro C.i.e.h.l.o.inc.	PR	Hearing and Speech Clinic/Center	$0	$1.6M
Jrc Maxillofacial Services,psc	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$1.5M
Caribe Physicians Plaza Corporation	PR	General Acute Care Hospital	$0	$1.4M
Fajardo Imaging Inc	PR	Magnetic Resonance Imaging (MRI) Clinic/Center	$0	$1.2M
Continuum Mental Care Corp	PR	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$972.3K
Laboratorio Clinico Fajardo, Inc.	PR	Clinical Medical Laboratory	$19.6K	$691K
Luis Arraut-ramirez	PR	Internal Medicine Physician	$0	$651.3K
Costa Este Medical Services Corp	PR	Health Maintenance Organization	$0	$637.5K

Jose J Lopez Agudo Oftalmologo Csp — Billing Profile & Reimbursement Data

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Jose J Lopez Agudo Oftalmologo Csp — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References