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.

Juan Conde San Miguel (NPI 1407238900)

Field	Value
Entity Type	Individual
Organization	Juan Conde San Miguel
Address	2225 Ponce Bypass Suite 407
City	Ponce
State	PR
ZIP	00717
Taxonomy	Hospitalist Physician
NPI Enumerated	June 22, 2015

Payer Source	Total Paid
Medicare	$95.2K
Medicaid	$0

Key Findings

This provider’s commercial payer footprint is effectively single-payer with respect to public programs: total Medicare revenue is $95.2K and there is no Medicaid billing on file. The absence of Medicaid activity means analyses of Medicaid mix, state-level Medicaid competitiveness, and dual-eligible overlap cannot be supported from these data.

Revenue is highly concentrated in a very small set of inpatient E/M codes: the precomputed top-3 Medicare codes account for 97.1% of this provider’s total Medicare revenue. Specifically, 99232 generates $72.2K (75.6% of Medicare revenue) and 99239 and 99222 generate $17.4K (18.3%) and $3.1K (3.2%) respectively, indicating that the practice’s revenue exposure is concentrated in hospital-based E/M and discharge management services.

The code mix strongly signals a hospitalist inpatient practice model: the top codes are 99232 (subsequent hospital inpatient/observation visits), 99239 (inpatient/observation discharge day management), and 99222 (initial hospital inpatient/observation care). This pattern—dominance of subsequent visit and discharge management codes—is consistent with clinicians providing ongoing inpatient management and transitional care rather than ambulatory primary care or procedural specialties.

Within national competitive standing on Medicare, the provider is a high-volume biller for 99232: 99232 shows 1.1K claims, $67 avg paid/claim, $72.2K revenue and ranks #4102 of 177383 providers nationally (98th percentile; notably above typical national volume for this code). By contrast, 99239 (178 claims, $98 avg paid/claim, $17.4K revenue) and 99222 (28 claims, $110 avg paid/claim, $3.1K revenue) rank in ranges described as typical or unremarkable for their respective national cohorts, so the provider’s national prominence is concentrated on that single high-volume subsequent-visit code.

Operational intensity is driven by volume rather than higher per-claim payments: 99232 accounts for the vast majority of claims activity (1.1K claims) at a modest average payment ($67 avg paid/claim), while higher average payments per claim appear on lower-volume codes (for example, 99222 at $110 avg paid/claim and 99239 at $98 avg paid/claim). This suggests day-to-day revenue and capacity planning will be sensitive to inpatient census and throughput rather than changes in per-claim reimbursement.

A closer read of lower-ranked E/M codes shows limited activity in high-complexity subsequent visits: 99233 appears with 27 claims, $104 avg paid/claim and $2.8K revenue and ranks #106754 of 128818 providers nationally (16th percentile; described as typical, unremarkable volume). That low percentile for 99233 indicates the provider bills relatively few high-complexity subsequent inpatient visits compared with peers, reinforcing the profile of frequent moderate-complexity follow-up and discharge management.

The provider has an established Medicare enrollment history, with the NPI enumerated on 2015-06-22 (~11 years ago). That tenure supports interpretation of observed patterns as stable practice behavior rather than a brief or transitional billing snapshot, but continued monitoring would be warranted to detect shifts in inpatient workload or any changes in payer mix.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,080	$70	$72.2K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	180	$100	$17.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	30	$110	$3.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$100	$2.8K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Juan Conde San Miguel — 1 of 4 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. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99233	150	170	70	$90	$9.4K
99232	3	220	80	$60	$7.9K
99239	3	40	30	$90	$5.3K
99222	33	150	20	$100	$2.4K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Juan Conde San Miguel, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Johns Hopkins Community Physicians, Inc	MD	Internal Medicine Physician	$0	$12.8M
Carmen Salvaterra	MD	Pulmonary Disease Physician	$8.9M	$0
Usacs Integrated Acute Care Services Of Maryland, LLC	MD	Internal Medicine Physician	$0	$7.7M
Naveed Shah	RI	Pulmonary Disease Physician	$1.4M	$0
Joshua Aaron	MD	Pulmonary Disease Physician	$443.6K	$44.6K
Abbas Omais	MD	Pulmonary Disease Physician	$454.3K	$9K
Daniel Kim	MD	Cardiovascular Disease Physician	$440K	$0
Alan Schneider	MD	Clinical Cardiac Electrophysiology Physician	$360.1K	$0
Joseph Ball	MD	Pulmonary Disease Physician	$359.9K	$0
Muhammad Shibli	DC	Pulmonary Disease Physician	$320.3K	$0

Nearby Providers

Other providers in the same ZIP code as Juan Conde San Miguel, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caribbean Imaging And Radiation Treatment Center,inc	PR	Multi-Specialty Clinic/Center	$0	$19.3M
Compression Health Care Inc	PR	Oxygen Equipment & Supplies (DME)	$0	$10.6M
Caribbean Cancer Care Services, LLC	PR	Medical Oncology Physician	$0	$6.5M
Oficina Medica Dr Quintero Psc	PR	Specialist	$0	$4.9M
Pet Diagnostic Imaging Corp	PR	Radiology Clinic/Center	$0	$4.8M
Hector Velez Cortes	PR	Hematology & Oncology Physician	$4.3K	$4M
Centro Oncologico De La Mujer De Puerto Rico Csp	PR	Oncology Clinic/Center	$0	$3.8M
Caribbean Wellness Oncology, Psc	PR	Hematology & Oncology Physician	$0	$3.6M
Jose Santiago Alvarado	PR	Anatomic Pathology & Clinical Pathology Physician	$17.2K	$3.2M
Dr German Chaves Radiologo Csp	PR	Diagnostic Radiology Physician	$0	$2.9M

Juan Conde San Miguel — Billing Profile & Reimbursement Data

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Juan Conde San Miguel — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References