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.

Aps Clinics Of Puerto Rico, Inc. (NPI 1336194448)

Field	Value
Entity Type	Organization
Organization	Aps Clinics Of Puerto Rico, Inc.
Address	Professional Offices Park, 966 San Roberto St.
City	San Juan
State	PR
ZIP	00926
Taxonomy	Adult Mental Health Clinic/Center
NPI Enumerated	May 24, 2006

Payer Source	Total Paid
Medicaid	$5.7M
Medicare	$0

Key Findings

APS CLINICS OF PUERTO RICO, INC. is effectively a Medicaid-focused provider: lifetime Medicare revenue is listed as none (no Medicare billing on file) while total Medicaid revenue is $5.7M, indicating a single-payer footprint concentrated on state Medicaid business. The provider’s NPI was enumerated on 2006-05-24 (~20 years ago), so this Medicaid-centric profile has been operating with an established enrollment for roughly two decades.

Revenue is highly concentrated in a small set of outpatient behavioral-health codes: the precomputed top 3 Medicaid codes by revenue account for 59.1% of the provider’s total Medicaid revenue, with 90832 ($1.4M, 24.7%), 99213 ($1.1M, 19.5%), and 90792 ($852.2K, 14.9%) driving the majority of billed dollars. That concentration suggests financial sensitivity to reimbursement or utilization changes affecting those specific psychotherapy, E/M, and psychiatric-evaluation codes.

The code mix indicates APS CLINICS operates as a high-volume mental health clinic delivering short psychotherapy sessions, routine office E/M visits, and psychiatric evaluations: 90832 (short psychotherapy, 353.4K claims, $4 avg paid/claim, $1.4M) and 90834 (38–52 minute psychotherapy, 67.7K claims, $3 avg paid/claim, $203.2K) together reflect a large psychotherapy caseload, while 90791/90792 (psychiatric evaluations, 59.2K and 94.7K claims respectively) show substantial diagnostic evaluation activity. The presence of 99347/99348/99349 home visit codes and multiple E/M codes (99212/99213/99214/99215) suggests a mixed service delivery model including office-based, home-based, and evaluation-focused care.

The provider’s operational model appears volume-driven with low average payments per claim: several top codes have very low avg paid/claim amounts (e.g., 90832 $4 avg paid/claim, 99213 $4 avg paid/claim, 90834 $3 avg paid/claim), meaning total revenue is achieved through very high claim counts rather than high per-encounter reimbursement. This structure implies revenue is sensitive to changes in claim volume, coding practices, or per-claim rates for commonly billed psychotherapy and E/M services.

APS CLINICS is a dominant statewide performer for multiple Medicaid codes: it ranks #1 of 317 providers in-state for 90832 (100th percentile; extreme outlier), #1 of 87 for 90792 (100th percentile; extreme outlier), and #1 of 360 for 90791 (100th percentile; extreme outlier). Several other codes show similarly extreme standing (e.g., 90853, 80305, 99347/99348/99349), indicating the clinic is an outlier in Puerto Rico for numerous behavioral health and related service lines rather than a modest local participant.

Not all high-volume claim lines produce revenue: 96127 shows 61.9K claims with $0 avg paid/claim and $0 revenue while still ranking #1 of 270 providers in-state (100th percentile; extreme outlier). The combination of very high claim counts and zero reported payment for 96127 suggests these assessments are being submitted but are not reimbursed under current Medicaid payment rules or are being recorded separately from paid services.

There are clear differences in competitive positioning across codes: 99213 is an extreme outlier statewide (278.4K claims, $1.1M, ranks #4 of 3229, 100th percentile; extreme outlier) while some routine E/M codes are at more typical volumes (for example, 99212 ranks #26 of 839 providers in-state, 97th percentile; typical, unremarkable volume). This mix shows APS CLINICS dominates specific service lines at an extreme level but is not uniformly the top performer across all common E/M CPTs.

Several telehealth/remote-contact codes and short-duration visit codes are prominent in the mix (e.g., 99442 84.6K claims, $5 avg paid/claim, $423K; 99443 19.1K claims, $8 avg paid/claim, $153K), indicating a significant portion of encounters may be delivered via brief or remote modalities. Combined with heavy volume in short psychotherapy codes (90832) and brief assessments, the billing pattern supports an operational focus on high-throughput, shorter encounters across in-person and remote settings.

Medicaid: Complete Services Breakdown

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

52 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	353,370	$1	$1.4M
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…	278,440	$1	$1.1M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	94,690	$10	$852.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	59,200	$10	$592K
99442	N/A	84,600	$10	$423K
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…	48,680	$10	$292.1K
99347	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at…	10,860	$20	$206.3K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	67,740	$1	$203.2K
99443	N/A	19,130	$10	$153K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	33,190	$1	$132.7K

Showing 1–10 of 52

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

Aps Clinics Of Puerto Rico, Inc. — 16 of 24 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

52 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…	8	280	210	$30	$43.8K
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…	3	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…	4	3,230	330	$10	$42.4K
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…	123	160	90	$90	$31.8K
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…	152	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…	200	530	100	$70	$22.9K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1	320	470	$10	$20K
99212	The 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,…	26	840	340	$1	$16.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	1	90	170	$10	$15.1K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	1	40	210	$10	$14.3K

Showing 1–10 of 52

Nearby Providers

Other providers in the same ZIP code as Aps Clinics Of Puerto Rico, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Farmacia Doral, Inc.	PR	Specialty Pharmacy	$0	$115.6M
Grupo Neonatal C.s.p.	PR	Neonatal-Perinatal Medicine Physician	$0	$6M
Alejandro Marmolejo	PR	General Practice Physician	$2.5K	$2.1M
Bvr Ambulance Best Care Inc	PR	Land Ambulance	$10.2K	$1.6M
Jan Rodriguez Ferrer	PR	Internal Medicine Physician	$60.6K	$1.4M
Nuvasive Pr, Inc.	PR	Durable Medical Equipment & Medical Supplies	$0	$1.2M
Rebeca Cuebas	PR	Pediatrics Physician	$0	$1M
Cck Medical Csp	PR	Cardiovascular Disease Physician	$0	$983K
Renato Rivera	PR	Family Medicine Physician	$0	$886.7K
Carlos Maldonado	PR	General Practice Dentistry	$0	$859K

Aps Clinics Of Puerto Rico, Inc. — Billing Profile & Reimbursement Data

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Aps Clinics Of Puerto Rico, 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