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    OpenPayerNPI Medicare & MedicaidHpm Foundation Inc
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    Hpm Foundation Inc — Billing Profile & Reimbursement Data

    NPI 1316167661 · San Juan, PR · Federally Qualified Health Center (FQHC)

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    Hpm Foundation Inc is a federally qualified health center (fqhc) provider located in San Juan, Puerto Rico. This profile covers 0 Medicare and 187 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationHpm Foundation Inc
    Address2020 Ave Borinquen
    CitySan Juan
    StatePR
    ZIP00915
    TaxonomyFederally Qualified Health Center (FQHC)
    NPI EnumeratedApril 27, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$2.8M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    187 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The 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…136,930$1$273.9K
    96160The 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…14,440$10$202.1K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth6,220$30$180.4K
    D1999N/A10,310$20$154.6K
    99050In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.5,900$30$147.6K
    99212The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…24,980$10$124.9K
    D0120Periodic oral evaluation - established patient6,410$20$96.2K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…4,380$20$65.6K
    D0272N/A4,330$20$65K
    D1120Prophylaxis–child3,350$20$63.6K

    Showing 1–10 of 187

    • More pages

    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.

    Full comparison — all codes billed, vs. Puerto Rico median

    187 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    92012For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…168350540$50$96.4K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…2327702,520$20$65.5K
    G2023Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source4715901,440$20$65.4K
    87635Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…186370370$50$63.3K
    D1110Prophylaxis - adult; cleaning and polishing of the teeth579901,060$30$53.1K
    80061The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.2568102,350$10$52.7K
    99050In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.15901,090$10$47K
    87591The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.45290170$30$43.8K
    87491The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.48310190$30$43.1K
    99214The 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…13900360$30$42.5K

    Showing 1–10 of 187

    • More pages

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Hpm Foundation IncPRClinical Medical Laboratory$0$2.7M

    Nearby Providers

    Other providers in the same ZIP code as Hpm Foundation Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Caribe Pharmacy Management LLCPRCommunity/Retail Pharmacy$15.1K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Puerto Rico Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    Hpm Foundation Inc — 9 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico