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.

South Renal Care, P.s.c (NPI 1295020790)

Field	Value
Entity Type	Organization
Organization	South Renal Care, P.s.c
Address	2275 Ponce By Pass
City	Ponce
State	PR
ZIP	00717
Taxonomy	Nephrology Physician
NPI Enumerated	June 13, 2011

Payer Source	Total Paid
Medicaid	$672.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 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…	5,360	$60	$321.7K
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…	2,660	$60	$162.1K
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…	1,660	$60	$98K
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…	1,090	$60	$64.5K
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…	350	$70	$23.1K
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…	20	$70	$1.6K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	30	$40	$1.1K
99442	N/A	20	$20	$340
1022F	No Summary found for this code	30	$0	$0
1159F	No Summary found for this code	3,230	$0	$0

Showing 1–10 of 20

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

South Renal Care, P.s.c — 1 of 8 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	37	390	290	$80	$96.8K
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…	100	460	200	$50	$60.3K
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…	44	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…	868	3,230	330	$10	$42.4K
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…	1,195	1,400	160	$50	$29.6K
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…	126	530	100	$70	$22.9K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	77	100	110	$40	$10.7K
99442	N/A	400	450	130	$10	$9K
3078F	No Summary found for this code	138	920	100	$1	$30
3074F	No Summary found for this code	143	870	110	$1	$30

Showing 1–10 of 20

Nearby Providers

Other providers in the same ZIP code as South Renal Care, P.s.c, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caribbean Imaging And Radiation Treatment Center,inc	PR	Multi-Specialty Clinic/Center	$0	$19.3M
Compression Health Care Inc	PR	Oxygen Equipment & Supplies (DME)	$0	$10.6M
Caribbean Cancer Care Services, LLC	PR	Medical Oncology Physician	$0	$6.5M
Oficina Medica Dr Quintero Psc	PR	Specialist	$0	$4.9M
Pet Diagnostic Imaging Corp	PR	Radiology Clinic/Center	$0	$4.8M
Hector Velez Cortes	PR	Hematology & Oncology Physician	$4.3K	$4M
Centro Oncologico De La Mujer De Puerto Rico Csp	PR	Oncology Clinic/Center	$0	$3.8M
Caribbean Wellness Oncology, Psc	PR	Hematology & Oncology Physician	$0	$3.6M
Jose Santiago Alvarado	PR	Anatomic Pathology & Clinical Pathology Physician	$17.2K	$3.2M
Dr German Chaves Radiologo Csp	PR	Diagnostic Radiology Physician	$0	$2.9M

South Renal Care, P.s.c — Billing Profile & Reimbursement Data

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South Renal Care, P.s.c — Billing Profile & Reimbursement Data

Sign up for South Renal Care, P.s.c — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References