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.

Recinto De Ciencias Medicas (NPI 1336218726)

Field	Value
Entity Type	Organization
Organization	Recinto De Ciencias Medicas
Address	Ave Americo Miranda Aptdo. 29134 Centro Medico De Pr
City	San Juan
State	PR
ZIP	00929
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	November 7, 2006

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

Key Findings

RECINTO DE CIENCIAS MEDICAS is effectively a Medicaid-focused neonatal-perinatal practice: there is no Medicare billing on file while lifetime Medicaid revenue is $5.4M, indicating the provider’s patient mix and billing activity are concentrated in Medicaid rather than Medicare. The NPI was enumerated on 2006-11-07 (~20 years ago), showing long tenure in the market but with activity visible primarily through Medicaid claims.

The provider’s Medicaid revenue is highly concentrated in neonatal critical care and follow-up codes: the top three Medicaid codes (99469, 99472, 99480) account for 83.9% of total Medicaid revenue, which signals that most billing is driven by intensive newborn and low-birth-weight infant management rather than routine outpatient visits. This concentration suggests a service-line focused on NICU and complex newborn care.

Code 99469 is the single largest revenue driver, generating $2.6M and representing 47.7% of the provider’s Medicaid revenue; RECINTO DE CIENCIAS MEDICAS ranks #1 of 6 in-state and is described as "notably above typical state volume for this code." That ranking and descriptive label indicate the provider is a dominant state-level source of subsequent neonatal critical care for infants under 28 days in neonatal critical care settings.

Code 99472 contributes $1.1M (20.1% of Medicaid revenue) and also ranks #1 of 4 in-state, but is characterized as having typical, unremarkable volume for the state despite the top rank. This suggests the provider captures leading volume for follow-up care of critically ill infants 29 days through 24 months, reinforcing its role in ongoing inpatient neonatal/young-child critical care management rather than primary newborn delivery services.

Code 99480 accounts for $871.8K (16.1% of Medicaid revenue) and ranks #1 of 2 in-state, again described as typical, unremarkable volume for this code. The presence of significant 99480 claims (directing care of recovering low birth weight infants between 2501 and 5000 grams) further underscores a specialty operational focus on managing recovering low-birth-weight neonates, supporting a NICU-centric business model.

Lower-revenue newborn codes appear alongside the NICU-dominant mix: 99460 and 99462 together account for about 10.3% of Medicaid revenue ($304.4K and $256.5K respectively) and the provider ranks in the 91st–92nd percentiles for these codes, indicating above-average but not leading statewide volume for routine newborn E/M services. This pattern implies the provider combines both high-acuity NICU care with a meaningful volume of standard newborn evaluations.

Several niche/high-acuity codes show smaller absolute revenue but suggest depth in specialty services: 99478 ($131K, ranks #1 of 1 in-state) and 99468 ($54.5K, ranks #3 of 4) indicate the provider bills for care of very low birthweight infants and initial critical care evaluations. Although these codes represent modest shares of total Medicaid revenue, their presence aligns with a comprehensive neonatal critical-care service line capable of treating a range of low-birth-weight and critically ill neonates.

Competitive standing across Medicaid codes is strong for the provider’s core NICU services: multiple top-1 statewide ranks and percentile labels (100th percentile for 99469, 99472, 99480) portray RECINTO DE CIENCIAS MEDICAS as a major in-state provider for neonatal critical care services, even as some codes are described as having "typical, unremarkable" volumes relative to peers. Taken together, the ranking and volume pattern indicate leadership in specialized neonatal care within Puerto Rico.

Given the long NPI tenure (~20 years) and the near absence of Medicare billing, payer mix is effectively single-payer dominated by Medicaid; analysts should treat this entity as Medicaid-centric when modeling revenue exposure, utilization, and competitive dynamics, and should not expect Medicare comparisons to be informative for this provider.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	7,410	$350	$2.6M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	3,420	$320	$1.1M
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	4,400	$200	$871.8K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	4,610	$70	$304.4K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	7,540	$30	$256.5K
99478	The provider directs the care of a recovering low birthweight infant, whose current weight is less than 1500 grams.	600	$220	$131K
99464	The provider is present during the delivery, at the request of the delivering provider, and during the basic stabilization of the newborn immediately after birth, typically when fetal distress or…	1,100	$70	$72.3K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	140	$390	$54.5K
99241	Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…	920	$20	$21.2K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	80	$190	$15.4K

Showing 1–10 of 13

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

Recinto De Ciencias Medicas — 3 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	1	10	740	$1,410	$2.9M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	850	$660	$860.2K
99480	The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.	1	10	3,240	$240	$792.5K
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	3	10	590	$500	$535.1K
99464	The provider is present during the delivery, at the request of the delivering provider, and during the basic stabilization of the newborn immediately after birth, typically when fetal distress or…	5	10	1,460	$70	$144.1K
99478	The provider directs the care of a recovering low birthweight infant, whose current weight is less than 1500 grams.	1	10	600	$220	$130.9K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	3	30	250	$40	$108.9K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	3	20	210	$70	$98.8K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	2	10	190	$300	$55.7K
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…	182	280	210	$30	$43.8K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Recinto De Ciencias Medicas, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Recinto De Ciencias Medicas	PR	Emergency Medicine Physician	$0	$6.8M
Recinto De Ciencias Medicas	PR	Diagnostic Radiology Physician	$0	$4.2M
Recinto De Ciencias Medicas	PR	Pediatrics Physician	$0	$4M
Recinto De Ciencias Medicas	PR	Obstetrics & Gynecology Physician	$0	$3.8M
Recinto De Ciencias Medicas	PR	Internal Medicine Physician	$0	$3.4M
Recinto De Ciencias Medicas	PR	Pediatric Cardiology Physician	$0	$3.1M
Recinto De Ciencias Medicas	PR	Clinical Medical Laboratory	$0	$3.1M
Recinto De Ciencias Medicas	PR	Orthopaedic Surgery Physician	$0	$3M
Recinto De Ciencias Medicas	PR	Maternal & Fetal Medicine Physician	$0	$2.7M
Recinto De Ciencias Medicas	PR	Ophthalmology Physician	$0	$2.4M

Nearby Providers

Other providers in the same ZIP code as Recinto De Ciencias Medicas, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Recinto De Ciencias Medicas	PR	Anesthesiology Physician	$0	$2.1M
Recinto De Ciencias Medicas	PR	Internal Medicine Physician	$0	$1.2M
Recinto De Ciencias Medicas	PR	Pediatric Hematology & Oncology Physician	$0	$879.8K
Jose Carlo-izquierdo	PR	Pain Medicine (Psychiatry & Neurology) Physician	$16.1K	$0

Recinto De Ciencias Medicas — Billing Profile & Reimbursement Data

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Recinto De Ciencias Medicas — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References