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.

Jorge Toro (NPI 1447247044)

Field	Value
Entity Type	Individual
Organization	Jorge Toro
Address	1028 Calle Los Angeles
City	San Juan
State	PR
ZIP	00923
Taxonomy	Nuclear Imaging & Therapy Physician
NPI Enumerated	September 29, 2005

Payer Source	Total Paid
Medicare	$255.8K
Medicaid	$0

Key Findings

JORGE TORO's Medicare billing profile is concentrated in nuclear medicine and PET imaging, with the highest-revenue items being A9596, 78815 and 78816. The top individual codes reported—A9596 (Gallium ga-68 gozetotide), 78815 (PET and CT fused imaging), and 78816 (PET/CT whole-body or limited area)—dominate the service mix and together form the clinical backbone of the practice's billed services. This code mix is consistent with a practice providing advanced PET diagnostic imaging rather than routine nuclear medicine procedures alone.

Revenue concentration is high: the precomputed top-3 codes account for 85.8% of the provider's total Medicare revenue. Individually those top codes are A9596 with $113.4K revenue (44.3% of total Medicare revenue), 78815 with $82.3K revenue (32.2% of total Medicare revenue), and 78816 with $23.7K revenue (9.3% of total Medicare revenue). This indicates a heavy dependence on a narrow set of PET-related services for overall Medicare dollars.

Payer mix is effectively single-payer Medicare: total Medicare revenue is $255.8K while there is no Medicaid billing on file. The absence of Medicaid activity means payer diversification is minimal and the business is reliant on Medicare volume and reimbursement trends for PET and radiopharmaceuticals.

Competitive standing by code is modest-to-typical at the national level rather than dominant. For the top revenue driver A9596 the provider ranks #80 of 168 (53th percentile; typical, unremarkable volume for this code), while 78815 ranks #2399 of 6566 (63th percentile; typical, unremarkable volume for this code) indicating a typical national footprint for PET/CT imaging; 78816 ranks #1246 of 1983 (34th percentile; typical, unremarkable volume for this code) suggesting below-median activity for that specific PET/CT CPT, and 78608 ranks #276 of 301 (0th percentile; typical, unremarkable volume for this code) reflecting participation in a smaller pool of providers for that brain PET code.

The mix of radiopharmaceutical and imaging codes (A9596 and A9552 paired with 78815/78816 and 78608) points to an oncology-focused PET service line that uses both Ga-68 gozetotide and FDG tracers. Having both A9596 (Ga-68 gozetotide) and A9552 (FDG f-18) billed suggests the practice accommodates tracer-specific indications and is set up to deliver tracer-dependent diagnostic exams rather than a single-tracer workflow.

Average paid amounts per claim show imaging procedures are higher-revenue per encounter than tracer supply codes, which helps explain revenue concentration. Examples in the file include $968 avg paid/claim for 78815, $1246 avg paid/claim for 78816, and $1203 avg paid/claim for 78608 compared with $810 avg paid/claim for A9596 and $399 avg paid/claim for A9552, indicating the procedure component contributes materially to overall receipts.

The provider has a long tenure in Medicare enrollment, with an NPI enumerated 2005-09-29 (~21 years ago), suggesting an established billing presence. Despite that longevity, the total Medicare revenue of $255.8K places the provider at a modest absolute scale nationally, reinforcing the characterization of a specialized but relatively small PET imaging operation rather than a high-volume center.

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A9596	Gallium ga-68 gozetotide, diagnostic, (illuccix), 1 millicurie	140	$810	$113.4K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	90	$970	$82.3K
78816	The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The…	20	$1,250	$23.7K
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	60	$400	$23.1K
78608	In this diagnostic procedure, the provider performs PET, positron emission tomography, a type of nuclear imaging test. It tells how the brain is functioning with information on metabolism, such as…	10	$1,200	$13.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Puerto Rico Distribution

Jorge Toro — 1 of 5 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

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A9596	1	10	140	$810	$113.4K
78815	1	10	30	$870	$35.7K
78816	5	10	20	$980	$23.5K
A9552	2	10	50	$410	$17.4K
78608	1	10	10	$1,200	$13.2K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Jorge Toro, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Centro Sononuclear De Rio Piedras	PR	Nuclear Medicine Physician	$0	$2.4M
Frank Gaudier Guerra	PR	Vascular & Interventional Radiology Physician	$19.8K	$51.8K
Iliana Alvarez Ramirez	PR	Diagnostic Radiology Physician	$35.1K	$10.1K
Tomas Jimenez Chafey	PR	Diagnostic Radiology Physician	$28.9K	$0
Marga Cardona Duran	PR	Diagnostic Radiology Physician	$15.2K	$0
Wilmarie Rivera Hernandez	PR	Diagnostic Radiology Physician	$5.2K	$0

Nearby Providers

Other providers in the same ZIP code as Jorge Toro, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
San Francisco Health System Inc	PR	General Acute Care Hospital	$0	$1.3M
Global Vytronics Psc	PR	Clinical Medical Laboratory	$0	$1.2M
Departamento De Salud Oficial	PR	Clinical Medical Laboratory	$0	$1M
Municipality Of San Juan Pr	PR	Land Ambulance	$41.3K	$812.2K
Mariana Cruz Manzano	PR	Dermatology Physician	$7.6K	$715.7K
Clinica Dental Barbosa Inc	PR	General Practice Dentistry	$0	$689.5K
Carlos Vives Alvarado	PR	Ophthalmology Physician	$16K	$345.5K
Magaly Flores Verdejo	PR	Clinical Medical Laboratory	$11K	$305.4K
Rene Ramirez-ortiz	PR	Ph.D. Medical Genetics	$3.1K	$176.6K
Hector Miranda Delgado	PR	Neurology Physician	$65.4K	$0

Jorge Toro — Billing Profile & Reimbursement Data

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Jorge Toro — 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