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.

Mario Loyola (NPI 1437278157)

Mario Loyola is a neurology with special qualifications in child neurology physician provider located in Mayaguez, Puerto Rico. This profile covers 0 Medicare and 16 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	Individual
Organization	Mario Loyola
Address	60 Calle Post N
City	Mayaguez
State	PR
ZIP	00680
Taxonomy	Neurology with Special Qualifications in Child Neurology Physician
NPI Enumerated	March 28, 2007

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	2,200	$120	$259.4K
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	510	$330	$168.3K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	870	$150	$131.9K
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…	1,020	$90	$86.9K
95957	In this procedure, the provider performs computer based analysis of an electroencephalogram, abbreviated as EEG.	540	$150	$78.6K
95930	The provider performs visual evoked potential testing that measures the electrical activity of the brain in response to a visual stimulus; however, this test is not used for VEP for glaucoma.…	1,110	$70	$73.5K
92585	N/A	650	$100	$66.4K
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,…	1,420	$30	$48.4K
95938	In this procedure, the provider performs a short–latency somatosensory evoked potential study by stimulating the peripheral nerves or skin sites in both the upper limbs and lower limbs. The provider…	210	$220	$45.8K
95925	In this procedure, the provider performs a short–latency somatosensory evoked potential study by stimulating the peripheral nerves or skin sites in the upper limbs. The provider records the resulting…	130	$160	$20.7K

Showing 1–10 of 16

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

Mario Loyola — 3 of 16 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95819	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	7	30	200	$260	$82.9K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	8	10	40	$220	$63.6K
95957	In this procedure, the provider performs computer based analysis of an electroencephalogram, abbreviated as EEG.	6	20	170	$140	$56K
95938	In this procedure, the provider performs a short–latency somatosensory evoked potential study by stimulating the peripheral nerves or skin sites in both the upper limbs and lower limbs. The provider…	1	10	210	$220	$45.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	50	280	210	$30	$43.8K
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…	254	900	360	$30	$42.5K
95930	The provider performs visual evoked potential testing that measures the electrical activity of the brain in response to a visual stimulus; however, this test is not used for VEP for glaucoma.…	1	10	560	$70	$37.2K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	21	160	90	$90	$31.8K
92585	N/A	2	10	40	$80	$22.6K
95925	In this procedure, the provider performs a short–latency somatosensory evoked potential study by stimulating the peripheral nerves or skin sites in the upper limbs. The provider records the resulting…	1	10	130	$160	$20.6K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Metro Mayaguez Inc	PR	General Acute Care Hospital	$0	$4.9M
Migrant Health Center Western Region,inc	PR	Clinical Medical Laboratory	$5.2K	$4.8M
Alameda Prosthodontic Services, Psc	PR	Prosthodontics	$0	$3.9M
Oscar Muniz	PR	Oral and Maxillofacial Pathology Dentistry	$0	$3.5M
Juan Garcia	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$2.9M
Migrant Health Center Western Region,inc	PR	Federally Qualified Health Center (FQHC)	$0	$2.4M
Centro Neumologico Del Oeste	PR	Pulmonary Disease Physician	$0	$2.2M
Lynette Baez Torres	PR	Ophthalmology Physician	$0	$1.9M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$0	$1.6M
Jesus Romero Perez	PR	Diagnostic Radiology Physician	$8.1K	$1.4M

Mario Loyola — 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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