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.

Southeastern Healthcare Holdings LLC (NPI 1467854877)

Field	Value
Entity Type	Organization
Organization	Southeastern Healthcare Holdings LLC
Address	1 Palmer Street Esq Vicente Pales
City	Guayama
State	PR
ZIP	00785
Taxonomy	Specialist
NPI Enumerated	September 17, 2014

Payer Source	Total Paid
Medicaid	$929.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

43 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9097	Home visit for wound care	4,730	$70	$311.9K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	3,090	$60	$194.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	2,620	$30	$88.9K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	3,260	$20	$71.6K
S9088	Services provided in an urgent care center (list in addition to code for service)	4,230	$10	$50.8K
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…	720	$60	$44.1K
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,…	870	$30	$24.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,010	$10	$21.1K
90649	This code represents a quadrivalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against four HPV types (6, 11, 16,…	550	$30	$17.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2,180	$10	$17.4K

Showing 1–10 of 43

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

Southeastern Healthcare Holdings LLC — 1 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

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9097	Home visit for wound care	11	20	4,150	$70	$761.3K
T1030	Nursing care, in the home, by registered nurse, per diem	22	30	1,360	$80	$228.4K
99345	The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…	3	10	2,630	$60	$154.8K
S9088	Services provided in an urgent care center (list in addition to code for service)	5	10	1,850	$20	$98.6K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	282	350	540	$50	$96.4K
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…	250	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…	325	900	360	$30	$42.5K
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…	812	3,230	330	$10	$42.4K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	276	440	370	$40	$38.5K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	333	530	630	$20	$32K

Showing 1–10 of 43

Nearby Providers

Other providers in the same ZIP code as Southeastern Healthcare Holdings LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Luis Lugo Rivera	PR	General Practice Physician	$3K	$1M
Advanced Physical Therapy Inc	PR	Home Health Agency	$0	$1M
Juan Rivera	PR	General Practice Physician	$0	$997K
Jose Rivera Rivera	PR	General Practice Dentistry	$0	$760.8K
Robert Santiago	PR	Physical Therapist	$5.8K	$0

Southeastern Healthcare Holdings LLC — Billing Profile & Reimbursement Data

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Southeastern Healthcare Holdings LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References