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.

Caribbean Heart Institute LLC (NPI 1285181164)

Key Findings

Field	Value
Entity Type	Organization
Organization	Caribbean Heart Institute LLC
Address	100 Ave Luis Munoz Marin Ste 305
City	Caguas
State	PR
ZIP	00725
Taxonomy	Clinical Cardiac Electrophysiology Physician
NPI Enumerated	September 8, 2016

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

This provider is effectively a single‑payer practice: there is no Medicare billing on file and all recorded lifetime revenue comes from Medicaid, totaling $5.7M. The absence of Medicare claims indicates the practice’s commercial footprint in federal fee‑for‑service Medicare is minimal or non‑existent, concentrating risk and reimbursement exposure in Medicaid.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 50.1% of this provider’s total Medicaid revenue. Specifically, 93306 generated $1.5M (26.6%), 33285 generated $700.3K (12.3%), and 99213 generated $635.5K (11.2%), together forming the majority of billed Medicaid dollars.

The code mix and descriptions indicate a cardiac electrophysiology and ambulatory diagnostics operation: high revenues from 33285 (insert cardiac rhythm monitor, $700.3K, $3467 avg paid/claim) and procedural monitoring codes such as 93224 (analyzed ECG recorder, 4.4K claims, $460.4K) point to device implantation and extended arrhythmia monitoring as core services. Concurrently, strong volumes in noninvasive vascular imaging (93880, 93925, 93970) and routine ECG services (93000, 93010) show the practice also performs high-throughput diagnostic testing.

Operationally the practice supports both ambulatory clinic flow and inpatient care: 99213 has 13.8K claims ($635.5K) reflecting heavy outpatient visit volume while 99232 has 5.2K claims ($505.7K) indicating substantial subsequent inpatient/observation encounters. This mix suggests the group runs high-volume clinic operations alongside hospital- or observation-based follow-up.

The provider is a dominant statewide performer on multiple high‑value and high‑volume Medicaid codes. 33285 ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), 93306 ranks #7 of 213 (97th percentile; extreme outlier, far above typical state volume), and 93880 ranks #1 of 49 (100th percentile; extreme outlier, far above typical state volume), signaling a market position of clear strength for device insertion and duplex vascular services within the state.

There is a meaningful dependence on higher‑paid device procedures to drive revenue: 33285’s average paid amount of $3467 per claim produced $700.3K in revenue, making it the single largest non‑E/M payer per claim in the top codes. This concentration on device reimbursement elevates sensitivity to changes in device coverage, coding, or prior authorization policies.

Several diagnostic and monitoring codes appear as statistical outliers in the state, reinforcing the clinical profile: 93224 (4.4K claims, $460.4K) ranks #2 of 85 (99th percentile; extreme outlier), 93000 (10.7K claims, $181.4K) ranks #8 of 410 (98th percentile; extreme outlier), and 93288 (2.2K claims, $83.1K) ranks #1 of 14 (100th percentile; extreme outlier). These elevated ranks indicate the practice performs monitoring and device management at volumes far above typical in‑state peers.

The provider’s NPI was enumerated on 2016-09-08 (~10 years ago), indicating an established tenure in the market. Combined with concentrated Medicaid revenue and multiple code-level outlier positions, this tenure supports the interpretation of an entrenched, specialty cardiac electrophysiology practice that is highly active in Medicaid-funded device and diagnostic services.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	6,930	$220	$1.5M
33285	The provider inserts a cardiac rhythm monitor with self–contained electrodes into a pocket in the tissues beneath the patient's skin and programs the device according to manufacturer’s directions.	200	$3,470	$700.3K
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…	13,820	$50	$635.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5,160	$100	$505.7K
93224	In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to detect abnormal heart rates and rhythms. He analyzes, compiles, and interprets the…	4,390	$110	$460.4K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	3,710	$120	$452.3K
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…	2,020	$160	$314.3K
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…	2,030	$120	$241.8K
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…	4,000	$60	$224.1K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	10,670	$20	$181.4K

Showing 1–10 of 31

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

Caribbean Heart Institute LLC — 12 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
33285	The provider inserts a cardiac rhythm monitor with self–contained electrodes into a pocket in the tissues beneath the patient's skin and programs the device according to manufacturer’s directions.	1	10	200	$3,470	$700.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	7	210	380	$210	$230.1K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	19	40	130	$210	$122.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	226	390	290	$80	$96.8K
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…	10	60	200	$110	$65.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	21	460	200	$50	$60.3K
93224	In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to detect abnormal heart rates and rhythms. He analyzes, compiles, and interprets the…	2	90	120	$110	$56.3K
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…	641	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…	147	3,230	330	$10	$42.4K
93784	The provider prescribes ambulatory blood pressure monitoring in which a patient wears a device continuously that automatically measures blood pressure at intervals over a period of 24 hours and…	2	10	520	$60	$39.2K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sasidhar Guthikonda	PR	Interventional Cardiology Physician	$132.2K	$0
Luis Jimenez Reyes	PR	Clinical Cardiac Electrophysiology Physician	$14.5K	$28.5K

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
Nuscan Csp	PR	Nuclear Medicine Physician	$0	$5.5M
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

Caribbean Heart Institute LLC — Billing Profile & Reimbursement Data

Sign up for Caribbean Heart Institute LLC — Billing Profile & Reimbursement Data policy alerts

Caribbean Heart Institute LLC — Billing Profile & Reimbursement Data

Sign up for Caribbean Heart Institute LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References