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NPI 1326356395 · Anasco, PR · Nephrology Physician
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Ronald Vigo Vigo is a nephrology physician provider located in Anasco, Puerto Rico. This profile covers 13 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Ronald Vigo Vigo |
| Address | 37 Calle San Antonio |
| City | Anasco |
| State | PR |
| ZIP | 00610 |
| Taxonomy | Nephrology Physician |
| NPI Enumerated | September 23, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $253.7K |
| Medicaid | $0 |
RONALD VIGO VIGO is a nephrology physician in ANASCO, PR with Medicare lifetime revenue of $253.7K and Medicaid revenue of $0, indicating he bills only Medicare in the available data. His NPI was enumerated on 2010-09-23 (~16 years ago), so the billing profile reflects roughly a decade-and-a-half of potential activity under that identifier.
Revenue concentration is high: the precomputed top 3 Medicare codes account for 75.0% of this provider's total Medicare revenue, driven primarily by 99232 (38.6%), 99223 (25.6%), and 99214 (10.8%). This concentration indicates that a small set of E/M hospital and outpatient codes dominate his Medicare dollars, which has business implications for revenue stability if inpatient volumes change.
The code mix—dominated by 99232 (1.5K claims, $65 avg paid/claim, $98.2K revenue) and 99223 (461 claims, $141 avg paid/claim, $65K revenue)—suggests a practice oriented toward hospital inpatient care rather than predominantly clinic-based outpatient work. Presence of dialysis-associated codes such as 90960 (49 claims, $282 avg paid/claim, $13.8K revenue) and 90935 (137 claims, $58 avg paid/claim, $7.9K revenue) also signals engagement in ESRD patient management and dialysis procedures alongside inpatient E/M services.
For competitive standing, the provider ranks as an extreme outlier nationally for his two largest codes: 99232 ranks #2311 of 177383 providers nationally (99th percentile; extreme outlier) and 99223 ranks #923 of 139583 providers nationally (99th percentile; extreme outlier). By contrast, his 99214 volume is typical for peers (rank #109509 of 479517 providers nationally, 77th percentile), so he appears exceptional specifically in high-volume inpatient E/M rather than across all outpatient E/M activity.
ESRD and dialysis activity is present but modest as a revenue driver: 90960 contributes $13.8K (5.4% of Medicare revenue) and ranks #5782 of 6549 providers nationally (11th percentile; typical, unremarkable volume), while 90935 contributes $7.9K (3.1%) and ranks #1102 of 6114 providers nationally (82th percentile; typical, unremarkable volume). These figures suggest he manages some monthly ESRD care and performs dialysis-related services, but those codes do not dominate his Medicare revenue.
Claim-level patterns reinforce an inpatient focus: 99232 shows very high claim volume (1.5K claims) with $98.2K revenue while 99223 has fewer claims (461) but higher average payment per claim ($141 avg paid/claim, $65K revenue), indicating a mix of frequent subsequent inpatient visits and a meaningful share of high-complexity initial inpatient encounters. Analysts should note the disparity between claim counts and avg paid/claim when evaluating service intensity and unit economics.
Critical-care and high-acuity signals exist but are not dominant: 99291 appears (18 claims, $177 avg paid/claim, $3.2K revenue, 1.3% of Medicare revenue) and ranks #59780 of 71290 providers nationally (14th percentile; typical, unremarkable volume), which indicates some critical-care involvement but at relatively low volume versus national peers. Combined with the strong inpatient E/M presence, this pattern is consistent with a nephrologist who consults on or manages hospitalized complex renal patients rather than serving primarily as a high-volume critical care specialist.
The payer mix is effectively single-payer Medicare in the available data (Medicare $253.7K vs. Medicaid $0), which has implications for network negotiation and patient mix—contracting, quality metrics, and care-management programs should be assessed with the understanding that Medicaid experience and claims history are not present in these records. Given this single-payer profile, payers and provider analysts should treat Medicaid readiness and state-level program participation as unverified by claims.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
13 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,510 | $70 | $98.2K |
| 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… | 460 | $140 | $65K |
| 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… | 280 | $100 | $27.5K |
| 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… | 150 | $100 | $14.6K |
| 90960 | The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the… | 50 | $280 | $13.8K |
| 99205 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider… | 60 | $170 | $10.9K |
| 90935 | Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally… | 140 | $60 | $7.9K |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 40 | $140 | $6.1K |
| 90970 | The provider manages for less than one full month all the daily services associated with the dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal… | 420 | $10 | $3.3K |
| 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… | 20 | $180 | $3.2K |
Showing 1–10 of 13
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 13 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99205 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider… | 10 | $0 | $0 |
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 10 | $0 | $0 |
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
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99215 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the… | 267 | 280 | 210 | $30 | $43.8K |
| 99205 | The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider… | 135 | 160 | 90 | $90 | $31.8K |
Other providers in the same ZIP code as Ronald Vigo Vigo, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Vqa Dental Services Psc | PR | General Practice Dentistry | $0 | $1.2M |
| Western Visual Care Psc | PR | Optometrist | $0 | $938.9K |
| Cindy Suarez Rivera | PR | Dentist | $0 | $609.9K |
| Walgreen Co | PR | Pharmacy | $59.9K | $0 |
| Farmacia Glorivee I LLC | PR | Community/Retail Pharmacy | $26.5K | $0 |
| Omar Vazquez | PR | Certified Registered Nurse Anesthetist | $12.2K | $0 |
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