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.

Island Perinatal, LLC (NPI 1396319752)

Island Perinatal, LLC is a maternal & fetal medicine physician provider located in Caguas, Puerto Rico. This profile covers 0 Medicare and 11 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	Island Perinatal, LLC
Address	Carr. 172 Caguas A Cidra, Urb Turabo Gardens
City	Caguas
State	PR
ZIP	00725
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	May 19, 2021

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	2,990	$150	$445.8K
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…	2,820	$140	$391.7K
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…	3,310	$110	$351.3K
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	4,190	$80	$322.6K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2,980	$100	$283.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	3,410	$80	$262.3K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	5,330	$40	$208K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	1,080	$80	$86.2K
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	130	$250	$30.8K
76827	The provider performs a complete fetal Doppler echocardiography by pulsed or continuous sound waves with spectral display to assess blood flow in the fetus.	140	$70	$9.7K

Showing 1–10 of 11

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

Island Perinatal, LLC — 3 of 11 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

11 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…	5	20	910	$110	$303K
76821	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the middle cerebral artery. This test determines the timing of labor induction and…	1	10	3,860	$70	$199.6K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	2	10	910	$70	$93.9K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	3	20	80	$70	$75.4K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	2	10	50	$40	$52.5K
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…	82	900	360	$30	$42.5K
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…	6	530	100	$70	$22.9K
76827	The provider performs a complete fetal Doppler echocardiography by pulsed or continuous sound waves with spectral display to assess blood flow in the fetus.	2	10	50	$50	$22.6K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	6	60	90	$50	$16.4K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	6	10	90	$40	$11.1K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Borinquen, Inc	PR	Clinical Medical Laboratory	$1.4M	$37.1M
Msl Therapeutical Services, Psc	PR	Occupational Therapist	$0	$12.8M
Laboratorio Clinico Bairoa Inc	PR	Clinical Medical Laboratory	$271.3K	$11.3M
Centro Medico Del Turabo Inc	PR	Multi-Specialty Clinic/Center	$0	$10.8M
Mediko Imaging Inc.	PR	Radiology Clinic/Center	$0	$6.8M
Consolidated Radiology Complex Csp	PR	Radiology Clinic/Center	$0	$6.8M
Caribbean Heart Institute LLC	PR	Clinical Cardiac Electrophysiology Physician	$0	$5.7M
Nuscan Csp	PR	Nuclear Medicine Physician	$0	$5.5M
Conmed Laboratories Inc	PR	Clinical Medical Laboratory	$105.5K	$5.4M
Sps Specialty Pharmacy Services Inc	PR	Specialty Pharmacy	$0	$4.2M

Island Perinatal, LLC — Billing Profile & Reimbursement Data

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Island Perinatal, LLC — 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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