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.

Hospital De La Concepcion Inc (NPI 1366484594)

Key Findings

Field	Value
Entity Type	Organization
Organization	Hospital De La Concepcion Inc
Address	Route #2 Km 173.4
City	San German
State	PR
ZIP	00683
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 12, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

HOSPITAL DE LA CONCEPCION INC reports no Medicare billing on file and $3.8M in lifetime Medicaid revenue, which makes its public payer footprint effectively single-payer Medicaid in the available data. This concentration means analyses of utilization and competitive position should be read as Medicaid-dominant rather than balanced across Medicare and Medicaid.

Revenue is highly concentrated in diagnostic imaging: the precomputed top three Medicaid codes — 74176 ($804.5K), 74177 ($756.4K), and 70450 ($508.3K) — together account for 58.4% of the provider’s total Medicaid revenue. That concentration on a small set of CT/diagnostic imaging codes indicates imaging services drive the majority of this hospital’s Medicaid billings.

The code mix points to a hospital operating with substantial imaging and acute diagnostic capacity. High-revenue CT codes (74176, 74177) and head CT (70450) plus meaningful volumes of echocardiography (93306) and routine ECGs (93010) suggest the facility is set up to support ED and inpatient diagnostic workflows rather than being primarily clinic- or ambulatory-based.

Against in-state peers the hospital sits in the upper tiers for its core CT volumes: 74177 ranks #6 of 67 providers in-state (92th percentile; typical, unremarkable volume for this code) and 74176 ranks #12 of 77 providers in-state (86th percentile). 70450 ranks #10 of 80 providers in-state (89th percentile). These rank/percentile placements indicate above-average statewide capacity for abdominal/pelvic and head CTs, placing the hospital in the upper cohort rather than as the single dominant statewide leader.

There are clear statistical outliers within the Medicaid profile. 93010 (ECG interpretation) shows 13.3K claims and $146.6K revenue and ranks #6 of 510 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code), signaling unusually high ECG throughput relative to peers and likely substantial inpatient or observation monitoring activity.

Basic radiography and point-of-care imaging volumes are also elevated relative to peers: 71046 (11.6K claims, $116.2K) ranks #13 of 262 providers (95th percentile; notably above typical), and 71045 (15.9K claims, $111.2K) ranks #15 of 215 providers (93th percentile). These patterns reinforce a high baseline of chest X‑ray and emergency/inpatient imaging throughput.

Inpatient evaluation-and-management activity is present but not extreme: 99232 shows 1.7K claims and $100.8K revenue and ranks #64 of 456 providers in-state (86th percentile), while 99222 (257 claims, $28K) ranks #98 of 320 (69th percentile). Those placements are consistent with a functioning general acute care hospital that carries routine inpatient caseloads alongside its imaging-heavy services.

The NPI was enumerated on 2006-06-12 (~20 years ago), indicating long-tenure operation in the market. Coupled with the concentrated imaging revenue profile and above-average statewide ranks on several diagnostic codes, the hospital appears to be an established Medicaid-focused acute care provider with particular strength in radiology and diagnostic throughput.

Medicaid: Complete Services Breakdown

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

77 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	5,120	$160	$804.5K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	4,670	$160	$756.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	5,910	$90	$508.3K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1,400	$140	$189.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	13,330	$10	$146.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	11,620	$10	$116.2K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	15,890	$10	$111.2K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	2,500	$40	$109.8K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	3,140	$30	$106.6K
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…	1,710	$60	$100.8K

Showing 1–10 of 77

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

Hospital De La Concepcion Inc — 2 of 25 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

77 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	12	80	900	$110	$242K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	45	210	380	$210	$230.1K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6	70	730	$110	$178.7K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	19	20	260	$250	$174.9K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	43	150	1,180	$70	$170.3K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	87	180	890	$70	$145.5K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	10	80	1,150	$50	$125.5K
77066	The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities…	111	130	480	$90	$109.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	371	500	220	$40	$79.5K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	11	20	40	$210	$65.6K

Showing 1–10 of 77

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gustavo Almodovar-mercado	PR	Otolaryngology Physician	$15K	$1.3M
Axel Baez-torres	PR	Anatomic Pathology & Clinical Pathology Physician	$6.3K	$738.4K
Francisco Guzman Lugo	PR	Cardiovascular Disease Physician	$9.6K	$695.2K
Axel Velez Santiago	PR	Pulmonary Disease Physician	$11.5K	$161.5K
Fernando Lopez Rodriguez	PR	Neuroradiology Physician	$41.6K	$37.6K
Anibal Lugo	PR	Cardiovascular Disease Physician	$10.8K	$810

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centro Cardiovascular De San German,csp	PR	Cardiovascular Disease Physician	$0	$4.6M
David Silva Caraballo	PR	Ophthalmology Physician	$6.8K	$4M
Southwest Health Corp.	PR	General Acute Care Hospital	$0	$1.8M
Western Hematology Oncology Group P.s.c	PR	Specialist	$0	$1.8M
Laboratorio Clinico Sangermeno Principal	PR	Clinical Medical Laboratory	$4.8K	$1.3M
San German X Ray & Body Imaging Center, Psc.	PR	Specialist	$0	$1.2M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$0	$1M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$0	$800.8K
Jorge Ramirez De Arellano	PR	Public Health Dentistry	$0	$626.5K
Natalia Ramirez Rodriguez	PR	General Practice Dentistry	$0	$457.4K

Hospital De La Concepcion Inc — Billing Profile & Reimbursement Data

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Hospital De La Concepcion 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

Related Providers

Nearby Providers

Frequently Asked Questions

References