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.

Hpm Foundation Inc (NPI 1417359142)

Hpm Foundation Inc is a clinical medical laboratory provider located in San Juan, Puerto Rico. This profile covers 0 Medicare and 80 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	Hpm Foundation Inc
Address	2020 Ave Borinquen
City	San Juan
State	PR
ZIP	00915
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	September 25, 2014

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

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

80 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	6,900	$50	$338.2K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	6,400	$30	$204.7K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	6,540	$30	$202.7K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	16,010	$10	$192.2K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	13,570	$10	$190K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	6,790	$20	$162.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	17,100	$10	$153.9K
80074	The lab analyst performs an acute hepatitis panel; the panel must include tests for hepatitis A IgM antibody, hepatitis B core IgM antibody, hepatitis B surface antigen, and hepatitis C antibody.	3,480	$40	$153.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	24,110	$10	$144.6K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	5,280	$20	$100.3K

Showing 1–10 of 80

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

Hpm Foundation Inc — 13 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

80 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87536	A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load.	30	40	250	$80	$140.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	198	650	1,260	$40	$93.7K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	40	770	2,520	$20	$65.5K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	49	590	1,440	$20	$65.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	12	370	370	$50	$63.3K
86360	The lab analyst performs a test to measure the number of CD4 and CD8 cells, typically in a blood specimen, including a calculation of the ratio between the two. The provider may order a CD4, CD8 and…	28	30	320	$40	$58.5K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	26	810	2,350	$10	$52.7K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	12	290	170	$30	$43.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	12	310	190	$30	$43.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	27	790	2,360	$10	$41.9K

Showing 1–10 of 80

Hpm Foundation Inc — Billing Profile & Reimbursement Data

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Hpm Foundation 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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