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.

Orthobone, Inc (NPI 1326360843)

Field	Value
Entity Type	Organization
Organization	Orthobone, Inc
Address	205 Calle Federico Costa Ste 103
City	San Juan
State	PR
ZIP	00918
Taxonomy	Customized Equipment (DME)
NPI Enumerated	February 25, 2010

Payer Source	Total Paid
Medicaid	$15.5M
Medicare	$0

Key Findings

ORTHOBONE, INC is registered as Customized Equipment (DME) and its Medicaid billing profile is dominated by prosthetic-implant activity: the top Medicaid code listed is L8699 (Prosthetic implant, not otherwise specified), indicating the operation primarily supplies high-cost prosthetic implants and related customized equipment rather than a broad mix of DME services. The provider is located in SAN JUAN, PR, which frames its market within Puerto Rico Medicaid dynamics.

Medicaid revenue is concentrated: lifetime Medicaid revenue is $15.5M and the precomputed top-3 share shows the top 3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue. In practice that concentration is entirely captured by a single code in the file, signaling very limited diversification of billed services within Medicaid.

The single listed Medicaid code L8699 accounts for the full $15.5M in revenue, with 3.8K claims and a $4072 avg paid/claim. This per-claim payment level is consistent with high-unit-cost prosthetic implants and indicates revenue generation comes from relatively few, high-dollar items rather than high-volume low-cost supplies.

Payer mix is effectively single-payer Medicaid: Medicare revenue is none (no Medicare billing on file), so the provider’s entire documented public-payer footprint is through Medicaid. That concentration in payer mix increases reliance on Medicaid policy and reimbursement changes and limits revenue diversification across federal payers.

Competitive standing for L8699 in-state is modestly strong: the provider ranks #5 of 23 in Puerto Rico and is noted at the 82th percentile, which the source characterizes as typical, unremarkable volume for this code. This rank indicates the provider is an established regional participant for prosthetic implants but not the dominant statewide supplier.

Statistically, the activity for L8699 is described as typical and not an outlier, meaning reported volumes fall within the expected state distribution for this code. Analysts should therefore view the provider’s utilization as consistent with peer behavior for prosthetic implant billing rather than anomalous.

Tenure is long enough to suggest an established billing presence: the NPI was enumerated 2010-02-25 (~16 years ago). This longevity supports the view that the provider has maintained a stable operational relationship with Medicaid payers over an extended period.

Operational and revenue-risk implications flow from the profile: the $4072 avg paid/claim and the 100.0% concentration in the top-3 Medicaid codes imply sensitivity to reimbursement edits, code reclassification, or prior-authorization changes affecting prosthetic implants. For analysts assessing contracting, audit focus, or competitive opportunity, the provider’s narrow product mix and Medicaid-only footprint are key factors to monitor.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
L8699	Prosthetic implant, not otherwise specified	3,800	$4,070	$15.5M

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

Orthobone, Inc — 0 of 1 code 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

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
L8699	Prosthetic implant, not otherwise specified	5	20	740	$2,660	$4.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio De Patologia Dr Noy	PR	Anatomic Pathology Physician	$0	$45.7M
Hato Rey Pathology Associates Inc	PR	Clinical Medical Laboratory	$58.5K	$42M
Home Orthopedics Corp	PR	Prosthetic/Orthotic Supplier	$0	$20.7M
Smith & Nephew Inc.	PR	Prosthetic/Orthotic Supplier	$0	$12M
Laboratorio Clinico Noy Inc	PR	Clinical Medical Laboratory	$76.1K	$9.9M
Servicios Radiologicos Asociados Jorge Perez Brais	PR	Diagnostic Radiology Physician	$0	$2.9M
Luis Torres Vera	PR	Allergy Physician	$21.5K	$2.7M
Inspira Psychiatric Services Psc	PR	Adult Mental Health Clinic/Center	$0	$2.5M
Frankie Alvarado	PR	Pulmonary Disease Physician	$7.3K	$2.4M
Boston Scientific Del Caribe, Inc	PR	Durable Medical Equipment & Medical Supplies	$0	$2.2M

Orthobone, Inc — Billing Profile & Reimbursement Data

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Orthobone, Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References