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.

Perinatology Group Psc (NPI 1164948766)

Perinatology Group Psc is a maternal & fetal medicine physician provider located in Caguas, Puerto Rico. This profile covers 0 Medicare and 12 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	Perinatology Group Psc
Address	Hopital Hima Caguas
City	Caguas
State	PR
ZIP	00725
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	August 16, 2017

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	3,890	$90	$330.9K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2,070	$130	$268.7K
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	3,860	$70	$266.1K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	3,590	$70	$240.2K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	6,820	$40	$238.8K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	3,070	$70	$218.3K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	1,110	$90	$96.2K
99402	At an encounter separate from a preventive medicine visit, the provider offers counseling related to subjects appropriate for the patient’s age, family history, and areas of concern. The subjects…	3,910	$20	$82.1K
93975	The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…	290	$180	$53.1K
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…	340	$80	$28.1K

Showing 1–10 of 12

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

Perinatology Group Psc — 5 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	7	20	910	$110	$303K
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	2	10	3,860	$70	$199.6K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	1	10	910	$70	$93.9K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2	20	80	$70	$75.4K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	1	10	50	$40	$52.5K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	45	220	290	$60	$47.2K
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…	1,587	3,230	330	$10	$42.4K
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…	100	120	130	$60	$26.9K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	126	160	150	$60	$26.5K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	1	60	90	$50	$16.4K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Borinquen, Inc	PR	Clinical Medical Laboratory	$1.4M	$37.1M
Msl Therapeutical Services, Psc	PR	Occupational Therapist	$0	$12.8M
Laboratorio Clinico Bairoa Inc	PR	Clinical Medical Laboratory	$271.3K	$11.3M
Centro Medico Del Turabo Inc	PR	Multi-Specialty Clinic/Center	$0	$10.8M
Mediko Imaging Inc.	PR	Radiology Clinic/Center	$0	$6.8M
Consolidated Radiology Complex Csp	PR	Radiology Clinic/Center	$0	$6.8M
Caribbean Heart Institute LLC	PR	Clinical Cardiac Electrophysiology Physician	$0	$5.7M
Nuscan Csp	PR	Nuclear Medicine Physician	$0	$5.5M
Conmed Laboratories Inc	PR	Clinical Medical Laboratory	$105.5K	$5.4M
Sps Specialty Pharmacy Services Inc	PR	Specialty Pharmacy	$0	$4.2M

Perinatology Group Psc — Billing Profile & Reimbursement Data

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Perinatology Group 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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