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.

Nuscan Csp (NPI 1275630527)

Key Findings

Field	Value
Entity Type	Organization
Organization	Nuscan Csp
Address	201 Ave Gautier Benitez
City	Caguas
State	PR
ZIP	00725
Taxonomy	Nuclear Medicine Physician
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$5.5M
Medicare	$0

This provider has no Medicare billing on file and reports $5.5M in lifetime Medicaid revenue, making its observable commercial/government payer footprint effectively single‑payer with Medicaid as the primary revenue source. Analysts should treat Medicaid policy and contracting as the principal driver of near‑term financial performance for this entity.

Revenue is heavily concentrated: the precomputed top 3 Medicaid codes account for 67.2% of the provider’s total Medicaid revenue. The largest contributors are 78816 ($2.4M, 42.6%), 78452 ($684.1K, 12.4%), and A9552 ($678.6K, 12.3%), indicating a small set of procedures drive most billing value.

The code mix is consistent with a nuclear medicine–centric operation: 78816 (FDG PET imaging) is the single largest line, supported by radiopharmaceutical supply codes such as A9552 and A9500, and by cardiac nuclear testing (78452). This pattern suggests the provider operates PET/CT and SPECT services and maintains on‑site or closely integrated radiotracer supply capability rather than being solely an ultrasound or general radiology practice.

In addition to nuclear studies, the provider reports substantial volumes of ultrasound and vascular diagnostic procedures, indicating a mixed‑modality imaging center. Notable examples include 76881 (7.7K claims, $430.9K, 7.8%) which ranks #2 of 30 in‑state at the 97th percentile (described as notably above typical state volume), and vascular duplex codes such as 93970 (2.4K claims, $259K, 4.7%) which ranks #3 of 73 in‑state at the 97th percentile and is labeled an extreme outlier.

Competitive standing within the state is stronger for certain lines and more modest for others: 78816 ranks #2 of 10 in‑state (89th percentile) so the provider is a leading, but not singularly dominant, PET supplier in Puerto Rico, while A9552 ranks #4 of 12 (around the 73rd percentile) which is typical volume versus peers. These ranks indicate the provider is a meaningful in‑state participant for nuclear imaging but operates in a competitive local market.

There are administrative/billing patterns worth noting: J7040 appears with 1.6K claims but an $0 avg paid/claim and $0 revenue, ranking #2 of 14 in‑state (92nd percentile). This combination of high claim count and zero paid amount suggests billing of units that did not generate Medicaid payments (e.g., pass‑through supply reporting, bundled reimbursement, or administrative coding artifacts) and should be reviewed when reconciling service volume against paid revenue.

The provider’s NPI was enumerated on 2006-09-20 (~20 years ago), signaling a long tenure in the market. That longevity, combined with concentrated Medicaid revenue from high‑value nuclear codes, suggests an established referral and operational footprint that could be sensitive to Medicaid reimbursement changes for radiopharmaceuticals and advanced imaging.

Because top procedures are highly concentrated (top 3 = 67.2%) and Medicaid supplies all reported revenue, shifts in reimbursement, utilization management, or prior‑authorization policies for PET radiotracers and cardiac nuclear imaging would likely have outsized impact on this provider’s revenue. The presence of high ultrasound and vascular volumes provides some service diversification, but Medicaid exposure remains the dominant financial risk factor.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
78816	The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The…	1,650	$1,430	$2.4M
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	1,900	$360	$684.1K
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	1,410	$480	$678.6K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	7,700	$60	$430.9K
A9500	Technetium tc-99m sestamibi, diagnostic, per study dose	1,810	$160	$283.7K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	2,380	$110	$259K
93015	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	1,800	$90	$163.5K
93925	The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts on both sides. Providers perform noninvasive arterial diagnostic procedures to examine the rate of…	1,250	$120	$153.9K
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.	2,340	$60	$144.8K
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…	1,770	$70	$120.4K

Showing 1–10 of 24

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

Nuscan Csp — 5 of 23 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
78816	The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The…	2	10	490	$1,200	$840.9K
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	4	10	830	$450	$450.4K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	4	20	260	$250	$174.9K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	178	180	890	$70	$145.5K
A9500	Technetium tc-99m sestamibi, diagnostic, per study dose	2	10	300	$160	$104.5K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	2	30	950	$60	$96.9K
J0153	Injection, adenosine, 1 mg (not to be used to report any adenosine phosphate compounds)	2	10	430	$110	$65.8K
93015	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	7	60	200	$110	$65.2K
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…	47	230	510	$60	$61K
78315	The provider performs a three–phase bone scan (also known as scintigraphy), a specialized nuclear medicine procedure in which the provider injects a radionuclide prior to imaging to examine the…	2	10	40	$180	$53.9K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Borinquen, Inc	PR	Clinical Medical Laboratory	$1.4M	$37.1M
Msl Therapeutical Services, Psc	PR	Occupational Therapist	$0	$12.8M
Laboratorio Clinico Bairoa Inc	PR	Clinical Medical Laboratory	$271.3K	$11.3M
Centro Medico Del Turabo Inc	PR	Multi-Specialty Clinic/Center	$0	$10.8M
Mediko Imaging Inc.	PR	Radiology Clinic/Center	$0	$6.8M
Consolidated Radiology Complex Csp	PR	Radiology Clinic/Center	$0	$6.8M
Caribbean Heart Institute LLC	PR	Clinical Cardiac Electrophysiology Physician	$0	$5.7M
Conmed Laboratories Inc	PR	Clinical Medical Laboratory	$105.5K	$5.4M
Sps Specialty Pharmacy Services Inc	PR	Specialty Pharmacy	$0	$4.2M
Advanced Hematology And Oncology Of Puerto Rico	PR	Hematology & Oncology Physician	$0	$3.6M

Nuscan Csp — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References