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.

Carlos Alcala Marquez (NPI 1295066124)

Field	Value
Entity Type	Individual
Organization	Carlos Alcala Marquez
Address	Ave Arterial Hostos # 239
City	San Juan
State	PR
ZIP	00918
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	January 15, 2010

Payer Source	Total Paid
Medicare	$17.6K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	90	$90	$8.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$120	$3.8K
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…	40	$70	$2.8K
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	50	$30	$1.3K
94200	The provider measures the largest volume of air that a patient can voluntarily breathe while the patient breathes as deeply and quickly as possible for a specified period of time. This test helps…	40	$10	$480
94664	The provider educates a patient on the use of an aerosol device, nebulizer, metered dose inhaler, or IPPB device and then has the patient demonstrate her understanding. He does this as part of the…	30	$10	$430
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	40	$10	$250

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Carlos Alcala Marquez — 0 of 7 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. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	59	170	70	$90	$9.4K
99223	49	200	20	$130	$4.9K
99213	876	1,530	50	$60	$4.2K
94375	15	20	80	$30	$2.8K
94200	11	10	80	$10	$1.6K
94664	5	10	40	$10	$510
94640	5	10	30	$10	$310

Carlos Alcala Marquez — Billing Profile & Reimbursement Data

Sign up for Carlos Alcala Marquez — Billing Profile & Reimbursement Data policy alerts

Carlos Alcala Marquez — Billing Profile & Reimbursement Data

Sign up for Carlos Alcala Marquez — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References