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.

Ruben Guadalupe (NPI 1194820993)

Ruben Guadalupe is a obstetrics & gynecology physician provider located in Humacao, Puerto Rico. This profile covers 0 Medicare and 20 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	Individual
Organization	Ruben Guadalupe
Address	Urb. San Antonio
City	Humacao
State	PR
ZIP	00791
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	September 14, 2006

Payer Source	Total Paid
Medicaid	$889.8K
Medicare	$0

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

20 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…	8,760	$40	$385.3K
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…	2,690	$50	$120.8K
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…	1,500	$70	$106.4K
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	3,880	$20	$89.2K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	4,380	$20	$74.5K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	1,660	$20	$39.7K
99204	The provider sees a new 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 provider…	310	$80	$25.3K
99459	The provider performs a pelvic exam on a patient in conjunction with an evaluation and management service.	1,270	$20	$22.9K
57150	In this procedure, the provider washes out the vaginal canal and may also instill medication when the patient has a bacterial, fungal, or parasitic disease.	210	$30	$5.5K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	930	$1	$3.7K

Showing 1–10 of 20

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

Ruben Guadalupe — 4 of 20 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	14	30	910	$40	$638.8K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	55	230	410	$40	$51.9K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	114	290	170	$30	$43.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	111	310	190	$30	$43.1K
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…	196	900	360	$30	$42.5K
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…	221	3,230	330	$10	$42.4K
57511	In this procedure, the provider uses cryocautery one or more times to destroy cervical tissue.	3	10	110	$110	$35.5K
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…	66	1,400	160	$50	$29.6K
99204	The provider sees a new 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 provider…	137	530	100	$70	$22.9K
57150	In this procedure, the provider washes out the vaginal canal and may also instill medication when the patient has a bacterial, fungal, or parasitic disease.	2	10	210	$40	$18.6K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dr Jose A Nassar & Asociados	PR	Radiology Clinic/Center	$0	$6.3M
Laboratorio Clinico Roxell Inc	PR	Clinical Medical Laboratory	$0	$1.9M
Redes De Salud Inc.	PR	Specialist	$0	$1.7M
Jimergency Medical Transport Inc.	PR	Ambulance	$46.2K	$1.5M
Yamilka Abreu Delgado	PR	Gastroenterology Physician	$0	$1.2M
Eastern Retina Consultants Of Puerto Rico, Psc	PR	Ophthalmology Physician	$0	$1.2M
Instituto De Radioterapia Avanzada Del Este, Psc	PR	Radiation Oncology Clinic/Center	$0	$1.1M
Servicios Anatomico Patologicos Oriental, Inc.	PR	Clinical Medical Laboratory	$2.6K	$1.1M
Vc Partners LLC	PR	Diagnostic Radiology Physician	$0	$1M
Ivette Rodriguez	PR	Pediatric Dentistry	$0	$936.9K

Ruben Guadalupe — Billing Profile & Reimbursement Data

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Ruben Guadalupe — 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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