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NPI 1194768150 · Juana Diaz, PR · General Practice Physician
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Glenda Rodriguez is a general practice physician provider located in Juana Diaz, Puerto Rico. This profile covers 5 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 | Glenda Rodriguez |
| Address | Carrion Maduro Street |
| City | Juana Diaz |
| State | PR |
| ZIP | 00795 |
| Taxonomy | General Practice Physician |
| NPI Enumerated | June 14, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $316.2K |
| Medicaid | $6.1K |
This provider is effectively Medicare-focused: lifetime Medicare revenue is $316.2K versus Medicaid revenue of $6.1K, so Medicare represents the overwhelming share of billed revenue. Medicaid activity exists but is economically immaterial compared with Medicare, indicating payer mix is highly skewed toward Medicare.
Medicare revenue is highly concentrated: the top 3 Medicare codes account for 99.5% of this provider's total Medicare revenue, with a single code, J0897, representing 94.2% of Medicare revenue. That concentration signals the practice is commercially dependent on a small set of injectable/drug-administration services rather than a broad mix of office E/M visits.
The code mix points to an infusion/injection service line rather than a traditional primary-care office practice: J0897 (denosumab injection) has 16.4K claims at $18 avg paid/claim yielding $294.9K in revenue, and administration codes 96365 and 96372 appear as the other material Medicare services. Together these codes (J0897, 96365, 96372) suggest routine, high-volume administration of an injectable biologic plus associated infusion and injection services.
Competitive standing for the key Medicare drug is strong: J0897 ranks #443 of 10057 providers nationally (96th percentile; notably above typical national volume), indicating this provider is a major national participant for that specific drug administration. By contrast, 96365 (rank #1128 of 8873, 87th percentile) and 96372 (rank #4029 of 58224, 93th percentile) are characterized in the data as typical, unremarkable volumes, so the provider's standout position is specific to J0897.
Medicaid billing is concentrated in emergency department E/M codes: 99282 accounts for $4K (64.2% of Medicaid revenue) and 99283 accounts for $2.2K (35.8% of Medicaid revenue), and the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue. In-state ranks show 99282 at #30 of 110 providers (72th percentile) and 99283 at #293 of 495 providers (41th percentile), indicating modest to typical ED-level Medicaid activity rather than a dominant statewide emergency-service footprint.
The provider has long tenure in the NPI registry: enumerated on 2006-06-14 (~20 years ago), which suggests an established billing history and sustained operational presence in the market. This length of enrollment supports interpretation of the observed, long-running specialization in injectable/infusion services.
Operational and financial dynamics are shaped by unit economics: J0897’s reported $18 avg paid/claim combined with very high claim volume (16.4K claims) produces the $294.9K Medicare revenue contribution for that code. The pattern — low per-claim payment but very high volume for a single drug — explains how one therapeutic code can dominate total Medicare revenue.
The extreme revenue concentration creates both strategic strength and vulnerability: specialization around J0897 and associated administration codes gives the provider leverage as a high-volume administrator of denosumab, but it also means changes in drug utilization, reimbursement policy, or supply could materially affect overall revenue. Monitoring payer coverage and utilization trends for J0897 should be a priority for understanding future revenue stability.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0897 | Injection, denosumab, 1 mg | 16,380 | $20 | $294.9K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 280 | $50 | $13.5K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 290 | $10 | $3.2K |
| 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,… | 20 | $50 | $1.1K |
| J3489 | Injection, zoledronic acid, 1 mg | 90 | $10 | $510 |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
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 |
|---|---|---|---|---|
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 270 | $20 | $4K |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 120 | $20 | $2.2K |
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 |
|---|---|---|---|---|---|---|
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 293 | 500 | 220 | $40 | $79.5K |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 30 | 110 | 70 | $30 | $14.3K |
Other providers in the same ZIP code as Glenda Rodriguez, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Southern Hospital Services Inc | PR | Emergency Care Clinic/Center | $0 | $2.4M |
| Laboratorio Clinico Profesional Emanuel Inc | PR | Clinical Medical Laboratory | $9.8K | $2.4M |
| Awilda Vazquez Quintana | PR | Physical Therapist | $0 | $1.3M |
| Southern Hospital Service Inc | PR | Clinical Medical Laboratory | $0 | $1M |
| Laboratorio Clinico Irizarry Guasch Inc | PR | Clinical Medical Laboratory | $0 | $852.7K |
| Maria J Lopez Aguado | PR | Clinical Medical Laboratory | $1.9K | $835.2K |
| Quality Care Hospice LLC | PR | Community Based Hospice Care Agency | $0 | $777.9K |
| Dr Jose E Martinez Campos Csp | PR | Medical Specialty Clinic/Center | $0 | $637.1K |
| Sonia Mercado Cruz | PR | Clinical Medical Laboratory | $140 | $612.3K |
| Walgreen Co | PR | Pharmacy | $103.1K | $0 |
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