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    v1.0.28
    OpenPayerNPI Medicare & MedicaidCosta Este Medical Services Corp
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    Costa Este Medical Services Corp — Billing Profile & Reimbursement Data

    NPI 1548430689 · Fajardo, PR · Health Maintenance Organization

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    Costa Este Medical Services Corp is a health maintenance organization provider located in Fajardo, Puerto Rico. This profile covers 0 Medicare and 63 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationCosta Este Medical Services Corp
    AddressF5 Calle Principal
    CityFajardo
    StatePR
    ZIP00738
    TaxonomyHealth Maintenance Organization
    NPI EnumeratedMarch 5, 2008

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$637.5K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    63 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99345The 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…4,580$60$279.6K
    S9097Home visit for wound care3,940$70$256.4K
    T1002Rn services, up to 15 minutes820$50$40K
    99211An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.1,140$30$33K
    96160The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…320$30$10.7K
    99215The 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…8,960$1$9K
    99203The 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…1,100$1$4.4K
    99205The 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…370$10$2.2K
    99341The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at least 15…10$70$840
    99050In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.80$10$650

    Showing 1–10 of 63

    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.

    Full comparison — all codes billed, vs. Puerto Rico median

    63 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    S9097Home visit for wound care13204,150$70$761.3K
    99345The 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…2102,630$60$154.8K
    84443The 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…5897702,520$20$65.5K
    80061The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.5818102,350$10$52.7K
    99050In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.79901,090$10$47K
    99215The 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…11280210$30$43.8K
    99214The 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…469900360$30$42.5K
    99213The 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…793,230330$10$42.4K
    80053The 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.6027902,360$10$41.9K
    85025A 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…6228503,250$10$40.5K

    Showing 1–10 of 63

    Nearby Providers

    Other providers in the same ZIP code as Costa Este Medical Services Corp, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Laboratorio Clinico Y De Ref De Fajardo IncPRClinical Medical Laboratory$26.2K$2.8M
    Servicios Medicos Integrados De Fajardo, P.s.c.PRGeneral Practice Physician$0$2.8M
    Centro C.i.e.h.l.o.inc.PRHearing and Speech Clinic/Center$0$1.6M
    Jrc Maxillofacial Services,pscPROral and Maxillofacial Surgery (Dentist)$0$1.5M
    Caribe Physicians Plaza CorporationPRGeneral Acute Care Hospital$0$1.4M
    Fajardo Imaging IncPRMagnetic Resonance Imaging (MRI) Clinic/Center$0$1.2M
    Continuum Mental Care CorpPRMental Health Clinic/Center (Including Community Mental Health Center)$0$972.3K
    Jose J Lopez Agudo Oftalmologo CspPROphthalmology Physician$0$763.5K
    Laboratorio Clinico Fajardo, Inc.PRClinical Medical Laboratory$19.6K$691K
    Luis Arraut-ramirezPRInternal Medicine Physician$0$651.3K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Puerto Rico Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    Costa Este Medical Services Corp — 1 of 12 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico