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NPI 1184614927 · San Juan, PR · Specialist
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Maximo Blondet Passalacqua is a specialist provider located in San Juan, Puerto Rico. This profile covers 14 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Maximo Blondet Passalacqua |
| Address | 400 Ave Fd Roosevelt |
| City | San Juan |
| State | PR |
| ZIP | 00918 |
| Taxonomy | Specialist |
| NPI Enumerated | October 24, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $114.7K |
| Medicaid | $7.6K |
This provider’s Medicare activity is focused on sleep medicine and pulmonary services: the top Medicare revenue code is 95811 (polysomnography monitoring >=6 hours) generating $51.1K (44.5% of Medicare revenue), and related procedures such as 95810 and 94660 also appear in the top codes. That code mix indicates the practice primarily delivers diagnostic and therapeutic sleep-disorder services (sleep studies and CPAP initiation) alongside pulmonary function testing.
Revenue concentration on Medicare is high: the precomputed top three Medicare codes account for 68.5% of the provider’s total Medicare revenue, signaling that a small set of high-yield sleep/pulmonary procedures are the main commercial drivers for Medicare business. This concentration suggests limited breadth of Medicare service lines.
Medicaid revenue is minimal relative to Medicare: total Medicare revenue is $114.7K versus total Medicaid revenue of $7.6K, indicating the provider operates with an effectively Medicare-dominant payer mix rather than a balanced dual-payer book. Medicaid represents a small share of lifetime public-payer receipts and likely plays a secondary role in practice economics.
On Medicare clinical volume standing, the provider is a modest to regionally notable participant for specific sleep and pulmonary codes: 95811 ranks #430 of 3427 nationally (87th percentile), and 94660 ranks #20 of 313 (94th percentile), which together indicate above-typical national volume for those sleep-related services while other E/M and PFT codes generally sit in middle percentiles. This profile is consistent with a specialist who concentrates referrals for sleep testing.
On Medicaid, billing is concentrated and modest in-state: the two Medicaid top codes (99213 and 99233) together account for 100.0% of the provider’s Medicaid revenue, with 99213 contributing $6.3K (82.5% of Medicaid revenue). In-state rankings (99213 at the 36th percentile and 99233 at the 21st percentile) mark the provider as a typical to below-typical Medicaid-volume participant for these E/M services within Puerto Rico.
Provider tenure shows long-term presence: the NPI was enumerated on 2005-10-24 (~21 years ago), indicating more than two decades of enrollment and potential continuity in the local referral network and payer relationships.
There is a notable contrast between high Medicare concentration in specialized procedures and Medicaid reliance on basic E/M visits: Medicare revenue is driven by specialized codes (e.g., 95811, 94660) while Medicaid revenue is driven entirely by routine E/M codes (99213 and 99233). This split implies the provider’s specialty services attract Medicare patients or referrals more than Medicaid patients, which may reflect payer access patterns or referral sources.
Several codes show differing competitive positions: 95811 is high relative to national peers (87th percentile) and 94660 is especially high (94th percentile), indicating above-typical specialization in CPAP initiation and extended polysomnography. By contrast, vaccination and some PFT codes (for example 90677 at the 7th percentile and 95810 at the 9th percentile) are low relative to peers, suggesting selective focus on core sleep services rather than broad preventive or ancillary services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 95811 | During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more. | 100 | $490 | $51.1K |
| 99214 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the… | 170 | $90 | $15.2K |
| 94660 | The provider initiates continuous positive airway pressure ventilation, or CPAP, typically for a patient with sleep apnea, or periodic cessation of breathing while asleep. He trains the patient on… | 260 | $50 | $12.4K |
| 95810 | Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,… | 10 | $490 | $6.8K |
| 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… | 100 | $70 | $6.5K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 70 | $90 | $6.3K |
| 90677 | This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the… | 10 | $280 | $3.3K |
| 94729 | In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream. | 80 | $40 | $3.2K |
| 94375 | The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to… | 110 | $30 | $3.1K |
| 94727 | The provider performs a pulmonary function test, or PFT, to assess the patient’s lung volumes using gas dilution or washout techniques that compare a known concentration of an inhaled gas with the… | 80 | $30 | $2.7K |
Showing 1–10 of 14
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 130 | $50 | $6.3K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 50 | $30 | $1.3K |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 301 | 390 | 290 | $80 | $96.8K |
| 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… | 2,069 | 3,230 | 330 | $10 | $42.4K |
Other providers in the same ZIP code as Maximo Blondet Passalacqua, ranked by combined Medicare and Medicaid revenue.
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