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.

Advantage Health Center LLC (NPI 1154097962)

Advantage Health Center LLC is a internal medicine physician provider located in San Juan, Puerto Rico. This profile covers 0 Medicare and 13 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	Advantage Health Center LLC
Address	15 Luis Munoz Rivera Ave
City	San Juan
State	PR
ZIP	00901
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 20, 2021

Payer Source	Total Paid
Medicaid	$741.6K
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	8,590	$20	$163.2K
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	6,340	$20	$120.5K
97032	Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…	8,880	$10	$115.5K
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…	1,370	$70	$95.7K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	1,370	$70	$90.5K
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…	1,060	$80	$85.7K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	7,940	$10	$63.5K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	300	$10	$3K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	350	$10	$2.8K
97018	In this procedure, the provider applies the paraffin wax on the joints or dips the limb in the paraffin wax solution.	50	$20	$910

Showing 1–10 of 13

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

Advantage Health Center LLC — 0 of 11 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	37	40	1,150	$40	$135.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	39	180	2,150	$20	$95.2K
97032	Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…	35	160	3,960	$20	$89.7K
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	26	110	2,080	$20	$72.3K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	105	130	3,370	$10	$64.5K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	57	80	1,220	$20	$51K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	15	70	510	$60	$44.8K
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…	956	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…	222	1,400	160	$50	$29.6K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	7	50	1,850	$10	$24.1K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fernando Villamil	PR	Orthopaedic Surgery of the Spine Physician	$187.3K	$0
Jose De La Cruz-napoli	PR	Cornea and External Diseases Specialist Physician	$55.1K	$50.5K
Federico Maestre Grau	PR	Ophthalmology Physician	$37.4K	$0
Baruch Caballero-valiente	PR	Cardiovascular Disease Physician	$19.4K	$0
Joanna Busquets Ferriol	PR	Dermatology Physician	$15.1K	$2.3K
Caribe Pharmacy Management LLC	PR	Community/Retail Pharmacy	$15.1K	$0

Advantage Health Center LLC — Billing Profile & Reimbursement Data

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Advantage Health Center LLC — 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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References