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.

Felix J Seda Ent Psc (NPI 1427088640)

Felix J Seda Ent Psc is a pediatric otolaryngology physician provider located in Santurce, Puerto Rico. This profile covers 0 Medicare and 13 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	Felix J Seda Ent Psc
Address	Ave San Jorge 252
City	Santurce
State	PR
ZIP	00912
Taxonomy	Pediatric Otolaryngology Physician
NPI Enumerated	July 4, 2006

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	5,970	$80	$495.1K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	3,080	$100	$320.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	4,430	$60	$274.6K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	3,820	$20	$57.2K
92588	The provider performs this noninvasive, diagnostic test to help detect inner ear abnormalities to identify such conditions as functional hearing loss or differentiate between sensory and neural…	1,000	$50	$50.1K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	1,010	$40	$38.5K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	830	$30	$24.8K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	240	$40	$9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	210	$30	$6.1K
92570	The provider uses this global service code which bundles a tympanometry, reflex threshold measurement, and reflex decay testing when the provider performs all three tests. This group of services…	250	$20	$6K

Showing 1–10 of 13

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

Felix J Seda Ent Psc — 2 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	19	230	410	$40	$51.9K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	2	20	70	$100	$50.3K
92588	The provider performs this noninvasive, diagnostic test to help detect inner ear abnormalities to identify such conditions as functional hearing loss or differentiate between sensory and neural…	15	50	410	$40	$50.1K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	402	3,230	330	$10	$42.4K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	14	1,400	160	$50	$29.6K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	28	50	410	$30	$27.8K
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…	421	530	100	$70	$22.9K
99242	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the…	17	90	170	$30	$18K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	473	840	340	$1	$16.7K
92550	The provider uses this global service code, which bundles tympanometry and reflex threshold measurement when the provider performs both tests to evaluate the middle ear and inner ear, respectively,…	5	10	130	$10	$16.6K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grupo Intensivo Pediatrico De San Juan	PR	Pediatric Critical Care Medicine Physician	$0	$5.5M
Ghp C.s.p.	PR	Pediatrics Physician	$0	$3.6M
Villegas LLC	PR	Ophthalmology Physician	$0	$1.3M
San Jorge Children's Medical Specialties,psc	PR	Oncology Clinic/Center	$0	$1.2M
Luis Font	PR	Pediatric Endocrinology Physician	$0	$836.4K
San Jorge Associates	PR	Anesthesiology Physician	$0	$656.6K
Rafael Trinidad Hernandez	PR	Endocrinology, Diabetes & Metabolism Physician	$14.1K	$173.5K
Edwardo Ramos Cortes	PR	Physical Medicine & Rehabilitation Physician	$19.3K	$134.4K
Jorge Rivera-herrera	PR	Urology Physician	$62.6K	$0
Jaime Pinero-pares	PR	General Practice Physician	$41K	$0

Felix J Seda Ent Psc — Billing Profile & Reimbursement Data

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Felix J Seda Ent Psc — 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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