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NPI 1225429533 · Rio Grande, PR · Emergency Care Clinic/Center
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Centro De Diagnostico Y Tratamiento De Rio Grande is a emergency care clinic/center provider located in Rio Grande, Puerto Rico. This profile covers 0 Medicare and 25 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 | Organization |
| Organization | Centro De Diagnostico Y Tratamiento De Rio Grande |
| Address | Numero 200 Calle Manuel Pimentel Y Castro |
| City | Rio Grande |
| State | PR |
| ZIP | 00745 |
| Taxonomy | Emergency Care Clinic/Center |
| NPI Enumerated | February 9, 2015 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.7M |
| Medicare | $0 |
This provider is effectively single‑payer Medicaid: there is no Medicare billing on file while total Medicaid revenue is $4.7M, indicating Medicaid is the sole reported public payer in the dataset for this NPI. Analysts should treat any Medicare-based benchmarking as inapplicable for this entity given the absence of Medicare claims.
Revenue is highly concentrated in a very small code set: the precomputed top three Medicaid codes account for 96.7% of the provider’s Medicaid revenue, with 99051 generating $3.4M (72.2% of Medicaid revenue) and S9083 generating $1.1M (23.5% of Medicaid revenue). This concentration means the provider’s financial performance is tightly linked to reimbursement and utilization patterns for these specific urgent/after‑hours service codes.
The taxonomy (Emergency Care Clinic/Center) and the dominant codes align: 99051 (after‑hours provider visits) and S9083 (global fee urgent care centers) together indicate the operation functions primarily as an urgent/after‑hours care center rather than a broad multispecialty clinic. The presence of numerous radiology and ultrasound codes at lower volumes suggests onsite or closely affiliated ancillary imaging services that support high‑throughput urgent care visits.
Competitive standing for the top codes is strong in‑state. 99051 ranks #5 of 80 providers (95th percentile) and is described as notably above typical state volume, while S9083 ranks #2 of 48 providers (98th percentile) and is also notably above typical state volume — together these ranks identify the provider as a major in‑state participant for urgent and after‑hours care.
Imaging and diagnostic procedures appear as secondary revenue streams: 71046 (chest radiographs) contributes $50.1K (1.1% of Medicaid revenue) and ranks #36 of 262 providers (87th percentile), while a spread of other X‑ray and ultrasound codes appear at generally typical or unremarkable volumes. These imaging services support the urgent care profile but represent a small share of total Medicaid revenue.
Operational throughput is high based on claim counts for top codes: 99051 has 33.3K claims with an average paid/claim of $103, and S9083 has 30.1K claims with an average paid/claim of $37. These volumes imply sustained patient visit frequency consistent with urgent care center operations and reinforce the revenue concentration in visit‑level services rather than high‑value procedures.
The provider has an established presence: the NPI was enumerated on 2015-02-09 (~11 years ago), which supports the interpretation that the current utilization pattern is mature rather than a short‑term anomaly. Longevity combined with top‑percentile ranks for urgent care codes suggests an entrenched role in the local emergency/urgent care market.
For payers and network managers evaluating contracting or utilization oversight, the extreme dependence on 99051 and S9083 (together accounting for the vast majority of Medicaid revenue) signals a focused negotiation target and a potential single‑service exposure. Monitoring shifts in after‑hours visit volume, reimbursement changes to these codes, or changes in ancillary imaging utilization will capture most of the provider’s Medicaid financial risk and performance.
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.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99051 | The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday. | 33,290 | $100 | $3.4M |
| S9083 | Global fee urgent care centers | 30,130 | $40 | $1.1M |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 5,570 | $10 | $50.1K |
| 76700 | An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code… | 980 | $40 | $42.3K |
| 72100 | The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays… | 1,980 | $10 | $21.8K |
| 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… | 250 | $40 | $11.1K |
| 76536 | The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review. | 220 | $50 | $11.1K |
| 74018 | Report this code for one X–ray view of the structures and organs in the abdomen to diagnose certain abdominal problems. | 960 | $10 | $8.7K |
| 73560 | In this procedure, the provider takes one or two X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 750 | $10 | $8.2K |
| 76770 | A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is… | 180 | $50 | $8.2K |
Showing 1–10 of 25
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
25 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99051 | The provider sees a patient during regular office hours that occur outside of traditional office hours, i.e., in the evening, on a weekend, or on a holiday. | 5 | 80 | 1,370 | $40 | $272.9K |
| S9083 | Global fee urgent care centers | 2 | 50 | 1,520 | $40 | $206K |
| 76700 | An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code… | 82 | 230 | 510 | $60 | $61K |
| 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,… | 220 | 230 | 410 | $40 | $51.9K |
| 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. | 199 | 220 | 290 | $60 | $47.2K |
| 76536 | The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review. | 99 | 170 | 310 | $60 | $46.5K |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 36 | 260 | 850 | $10 | $27.8K |
| 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… | 63 | 160 | 150 | $60 | $26.5K |
| 76770 | A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is… | 82 | 160 | 180 | $60 | $24.4K |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 89 | 220 | 470 | $10 | $22.6K |
Showing 1–10 of 25
Other providers in the same ZIP code as Centro De Diagnostico Y Tratamiento De Rio Grande, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Raul Medina | PR | Land Ambulance | $9.7K | $4.6M |
| Laboratorio Clinico Chegar Inc | PR | Clinical Medical Laboratory | $8.8K | $1.9M |
| Fajardo Imaging Mri Csp | PR | Mammography Clinic/Center | $0 | $1.1M |
| Centro De Medicina Fisica Y Rehabilitacion Rio Grande,inc | PR | Physical Therapy Clinic/Center | $0 | $680.3K |
| Walgreen Co. | PR | Pharmacy | $129K | $0 |
| Aracelis Mendoza | PR | Clinical Medical Laboratory | $0 | $2.5K |
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