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.

Ct Radiology Complex, LLC (NPI 1558356493)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ct Radiology Complex, LLC
Address	1815 Rd 2
City	Bayamon
State	PR
ZIP	00959
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	September 16, 2005

Payer Source	Total Paid
Medicaid	$6.2M
Medicare	$0

CT RADIOLOGY COMPLEX, LLC reports no Medicare billing on file and $6.2M in lifetime Medicaid revenue, making its activity effectively single-payer (Medicaid) at the scale reflected here. The absence of Medicare claims indicates Medicaid is the primary commercial payer relationship captured in our data rather than a balanced Medicare/Medicaid mix.

Revenue is concentrated: the precomputed top three Medicaid codes account for 36.7% of the provider's total Medicaid revenue. Those top three contributors are 76641 ($826.3K, 14.6%), 77067 ($696.4K, 12.3%), and 77066 ($560K, 9.9%), so breast imaging procedures drive a substantial share of the practice’s Medicaid revenue.

The code mix and top revenue-driving codes indicate a strong breast imaging and ultrasound emphasis: 76641 (complete breast ultrasound), 77067 (screening mammography with computer-aided detection), and 77066 (diagnostic mammography with CAD) together dominate revenue and suggest the practice operates as a high-volume outpatient breast imaging center. High counts on adjacent ultrasound codes (e.g., 76700, 76536, 76881, 76830) reinforce an operational focus on sonography-based diagnostics across abdominal, soft-tissue, pelvic and joint exams.

Beyond breast services, the provider offers broad modality capability: significant Medicaid revenue appears in MRI (72148 lumbar MRI, $312K), nuclear medicine (78315 three-phase bone scan, $197.6K; 78306 full-body bone scan, $139.8K), cardiology SPECT (78452, $286.5K), and vascular duplex studies (93970, $134.5K; 93925, $58.9K). This spread of codes implies a multi-modality outpatient imaging practice that performs cross-sectional imaging, nuclear studies, cardiac SPECT, and vascular ultrasound in addition to mammography and general ultrasound.

CT RADIOLOGY COMPLEX is a dominant statewide provider for several breast and screening services: 77066 ranks #2 of 133 providers in-state (99th percentile, labeled an extreme outlier), 76641 ranks #5 of 183 (98th percentile), and 77067 ranks #5 of 153 (97th percentile). These rank/percentile positions indicate the practice is a major player in Puerto Rico for breast imaging volume, well above typical state volumes for these codes.

Certain codes are flagged as statistical outliers or extreme outliers for in-state volume, signaling unusually high utilization in specific inputs and services. Notably, 77066 and 77080 (DXA) are described as "extreme outlier, far above typical state volume," Q9967 (low osmolar contrast material) is rank #1 of 21 (100th percentile; extreme outlier), and A9503 and A9500 also appear at or near top ranks — together these suggest heavy use of contrast and radionuclide supplies consistent with extensive contrast-enhanced imaging and nuclear medicine activity.

While some services are unusually high volume, several other modalities register typical or unremarkable volumes relative to peers: 78452 SPECT cardiac studies (68th percentile), 93306 echocardiography (65th percentile), and a number of MRI and ultrasound codes fall in the mid-to-high percentiles but are described as typical. This pattern points to particular concentration in breast imaging and screening/DXA while maintaining a more standard state-level footprint for some advanced cardiac and echocardiographic services.

The provider has longstanding credentialing tenure, with an NPI enumerated on 2005-09-16 (~21 years ago). Combined with its concentrated Medicaid revenue and high statewide ranks on multiple screening and breast imaging codes, this tenure is consistent with an established outpatient imaging center with sustained referral streams in the Puerto Rico Medicaid market.

Medicaid: Complete Services Breakdown

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

64 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	10,870	$80	$826.3K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	9,950	$70	$696.4K
77066	The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities…	7,000	$80	$560K
72148	In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast.	1,300	$240	$312K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	3,970	$80	$301.8K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	680	$420	$286.5K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	3,980	$70	$262.4K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	4,060	$60	$243.5K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	2,990	$80	$236K
78315	The provider performs a three–phase bone scan (also known as scintigraphy), a specialized nuclear medicine procedure in which the provider injects a radionuclide prior to imaging to examine the…	1,120	$180	$197.6K

Showing 1–10 of 64

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

Ct Radiology Complex, LLC — 11 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

64 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	10	10	490	$1,200	$840.9K
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	9	10	830	$450	$450.4K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	63	80	900	$110	$242K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	75	210	380	$210	$230.1K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	53	70	730	$110	$178.7K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	7	20	260	$250	$174.9K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	5	150	1,180	$70	$170.3K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	5	180	890	$70	$145.5K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	73	80	1,150	$50	$125.5K
19499	Use this code to report a procedure on the breast for which there is no specific code available.	3	10	370	$270	$112.8K

Showing 1–10 of 64

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ruben Diaz - Rodriguez	PR	Pediatric Cardiology Physician	$0	$3.9M
Pk Industries Corp	PR	Oxygen Equipment & Supplies (DME)	$0	$3.3M
Doctors Center Hospital Bayamon Inc	PR	General Acute Care Hospital	$0	$3.1M
Laboratorios Clinico Bayamon Inc	PR	Clinical Medical Laboratory	$14K	$2.5M
Bayamon Medical Center Corp	PR	General Acute Care Hospital	$0	$2.3M
New Vision Medical Diagnostics Inc	PR	Clinical Medical Laboratory	$0	$1.9M
Centro De Patologia Avanzada De Pr Csp	PR	Clinical Pathology/Laboratory Medicine Physician	$0	$1.8M
Vitreo Retinal Consultants, Psc	PR	Specialist	$0	$1.5M
Stereotactic Breast Center Psc	PR	Ambulatory Surgical Clinic/Center	$0	$1.3M
Santiago Coste-sibilia	PR	Gastroenterology Physician	$4.2K	$1.3M

Ct Radiology Complex, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References