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.

Family Medicine Group Inc. (NPI 1265732184)

Field	Value
Entity Type	Organization
Organization	Family Medicine Group Inc.
Address	Ave. Roberto Clemente 124 #8
City	Carolina
State	PR
ZIP	00985
Taxonomy	Adult Medicine Physician
NPI Enumerated	October 26, 2010

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

108 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	99,670	$1	$398.7K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	2,650	$60	$151.2K
99441	N/A	22,410	$1	$67.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	12,030	$10	$60.1K
0012A	N/A	1,380	$30	$46.9K
0011A	N/A	1,390	$30	$41.7K
0003A	N/A	940	$40	$34.8K
96160	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…	960	$30	$32.5K
99442	N/A	6,350	$10	$31.8K
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…	7,050	$1	$28.2K

Showing 1–10 of 108

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

Family Medicine Group Inc. — 8 of 25 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

108 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9097	Home visit for wound care	21	20	4,150	$70	$761.3K
S9083	Global fee urgent care centers	14	50	1,520	$40	$206K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	4	10	2,630	$60	$154.8K
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	9	90	1,090	$10	$47K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	213	280	210	$30	$43.8K
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…	2	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…	49	3,230	330	$10	$42.4K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	98	160	90	$90	$31.8K
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…	294	1,400	160	$50	$29.6K
0002A	N/A	70	160	310	$30	$23.3K

Showing 1–10 of 108

Related Providers

Other providers that share a Tax Identification Number (TIN) with Family Medicine Group Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Luz Mundo Rodriguez	PR	Pediatrics Physician	$0	$662.3K

Nearby Providers

Other providers in the same ZIP code as Family Medicine Group Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Instituto De Ojos Y Piel, Inc	PR	Optometrist	$0	$3.2M
Clinical Medical Services Inc	PR	Durable Medical Equipment & Medical Supplies	$0	$2.4M
Health Laboratories Services Inc	PR	Clinical Medical Laboratory	$28.3K	$2.3M
Ada Colon-gavillan	PR	Physical Therapy Clinic/Center	$0	$1.4M
Pedro Rivera Caballero	PR	General Practice Physician	$3.1K	$1.3M
Rivera-revilla Lab LLC	PR	Clinical Medical Laboratory	$4K	$1.3M
Centro Radiodiagnostico Carolina	PR	Diagnostic Radiology Physician	$0	$1.2M
Juan Ledoux	PR	General Practice Dentistry	$0	$968K
Milab LLC	PR	Clinical Medical Laboratory	$1.9K	$889.3K
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$789.3K

Family Medicine Group Inc. — Billing Profile & Reimbursement Data

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Family Medicine Group Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References