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.

Benigno Lopez (NPI 1215017819)

Benigno Lopez is a orthopaedic surgery physician provider located in Caguas, Puerto Rico. This profile covers 0 Medicare and 22 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	Benigno Lopez
Address	Edif. Hima San Pablo Cirugia Ambulatoria
City	Caguas
State	PR
ZIP	00726
Taxonomy	Orthopaedic Surgery Physician
NPI Enumerated	October 17, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	6,010	$90	$511.1K
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…	6,690	$50	$328K
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…	7,110	$20	$135.1K
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…	7,110	$10	$92.5K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	7,110	$10	$92.5K
29515	The provider applies a short leg splint to treat injuries of the leg, including fractures, dislocations, and sprains of the lower leg, ankle, and foot. The splint covers and immobilizes the lower leg…	420	$50	$22.5K
29425	The provider applies a cast to the lower leg to treat a fracture of one or both bones of the lower leg, the tibia and fibula, or a severe ankle sprain. She forms the bottom of the cast to accommodate…	420	$50	$22K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	3,200	$10	$19.2K
29075	The provider applies a cast encasing the lower arm. A short arm cast treats fractures of the bones in the lower arm and corrects deformities of the hand and wrist.	160	$50	$8.9K
Q4037	Cast supplies, short leg cast, adult (11 years +), plaster	330	$20	$7.6K

Showing 1–10 of 22

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

Benigno Lopez — 3 of 22 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	42	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…	49	160	3,960	$20	$89.7K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	31	130	3,370	$10	$64.5K
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…	283	3,230	330	$10	$42.4K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	18	50	1,850	$10	$24.1K
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…	2	530	100	$70	$22.9K
29425	The provider applies a cast to the lower leg to treat a fracture of one or both bones of the lower leg, the tibia and fibula, or a severe ankle sprain. She forms the bottom of the cast to accommodate…	1	10	420	$50	$21.9K
73110	The provider takes at least three X–ray images of a patient’s complete wrist to check for any fracture, swelling, or reason of pain in the wrist area.	4	10	70	$30	$8.1K
Q4045	Cast supplies, short leg splint, adult (11 years +), plaster	1	10	350	$20	$7.1K
29515	The provider applies a short leg splint to treat injuries of the leg, including fractures, dislocations, and sprains of the lower leg, ankle, and foot. The splint covers and immobilizes the lower leg…	1	10	60	$50	$6.4K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Francisco Ojeda	PR	General Practice Physician	$0	$818.2K
Crm Grupo Profesional Medicos, Csp	PR	Primary Care Clinic/Center	$0	$662.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jose Diaz-abascal	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$3.8M
David Vazquez-morales	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$3.1M
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$1.7M
St Lukes Episcopal Church Home Care Program	PR	Home Health Agency	$0	$1.1M
Rafael Figueroa	PR	Specialist	$0	$731.1K
Hector Ramos-fuentes	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$656.4K
Elissa Carrera Gonzalez	PR	Internal Medicine Physician	$24K	$0
Luis Ferrer Torres	PR	Anatomic Pathology & Clinical Pathology Physician	$9.1K	$0
Armando Sanchez Burgos	PR	General Practice Physician	$5.1K	$0

Benigno Lopez — 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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