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.

Dorado Health Inc (NPI 1376605170)

Dorado Health Inc is a general acute care hospital provider located in Manati, Puerto Rico. This profile covers 0 Medicare and 47 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Dorado Health Inc
Address	Calle Hernandez Carrion
City	Manati
State	PR
ZIP	00674
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 15, 2006

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

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

47 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.	4,990	$190	$958.1K
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.	22,100	$40	$950.2K
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.	3,060	$100	$315.5K
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.	1,340	$200	$272K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2,100	$90	$184.8K
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…	980	$160	$156K
50590	Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters.	160	$600	$95.5K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	1,400	$60	$80K
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…	9,630	$10	$77K
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…	5,870	$10	$64.6K

Showing 1–10 of 47

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

Dorado Health Inc — 3 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

47 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	12	20	910	$110	$303K
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.	14	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…	68	210	380	$210	$230.1K
50590	Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters.	8	20	120	$580	$193.3K
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.	24	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…	12	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…	151	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.	74	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.	22	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…	53	130	480	$90	$109.4K

Showing 1–10 of 47

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valentin Del Rio Santiago	PR	Interventional Cardiology Physician	$23.9K	$65.1K
Antonio Diaz	PR	Mammography Clinic/Center	$51.2K	$0
Porfirio Franqui	PR	Family Medicine Physician	$16.7K	$0
Julio Valentin Nieves	PR	Interventional Cardiology Physician	$13.1K	$0
Ricardo Santiago	PR	Interventional Cardiology Physician	$9.9K	$710
Eduardo Pascual	PR	Nuclear Medicine Physician	$7.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Pathology Csp	PR	Clinical Medical Laboratory	$0	$16.9M
Pci Group LLC	PR	Interventional Cardiology Physician	$0	$9.6M
Centro Cardiovascular De Manati Iii Csp	PR	Cardiovascular Disease Physician	$0	$5.7M
Anestesia Del Norte P.s.c.	PR	Specialist	$0	$5M
Mogic Ob-gyn Psc	PR	Obstetrics & Gynecology Physician	$0	$4.9M
Dentistas Asociados Del Norte	PR	General Practice Dentistry	$0	$3M
Crilomil Corp.	PR	Pediatric Dentistry	$0	$2.8M
Hospitalist Medical Services, Psc	PR	Anesthesiology Physician	$0	$2.7M
Atlantic Pathology	PR	Clinical Medical Laboratory	$0	$2.5M
Centro Imagenes Manati Yvf Psc	PR	Diagnostic Radiology Physician	$0	$2.3M

Dorado Health Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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