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.

Juan Rivera (NPI 1578559423)

Field	Value
Entity Type	Individual
Organization	Juan Rivera
Address	Edif La Palma
City	Mayaguez
State	PR
ZIP	00680
Taxonomy	Pediatric Dentistry
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

17 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D1120	Prophylaxis–child	10,230	$20	$194.3K
D1208	Topical application of fluoride - excluding varnish	11,930	$10	$167.1K
D1999	N/A	8,370	$20	$125.6K
D0120	Periodic oral evaluation - established patient	8,420	$10	$117.8K
D0150	Comprehensive oral evaluation – new or established patient	5,670	$20	$113.5K
D0330	N/A	3,390	$30	$101.7K
D0272	N/A	4,900	$10	$68.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	2,460	$30	$66.3K
D2150	Amalgam - two surfaces, primary or permanent	580	$40	$23.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	410	$40	$17.4K

Showing 1–10 of 17

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

Juan Rivera — 4 of 17 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

17 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	281	990	1,060	$30	$53.1K
D1999	N/A	49	950	1,350	$10	$35.1K
D2930	N/A	7	10	90	$50	$26.6K
D0330	N/A	32	540	370	$30	$25.3K
D0120	Periodic oral evaluation - established patient	22	940	880	$10	$24.2K
D0272	N/A	54	880	710	$10	$20.7K
D2150	Amalgam - two surfaces, primary or permanent	159	550	210	$40	$20.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	127	410	180	$40	$18.5K
D0150	Comprehensive oral evaluation – new or established patient	7	910	540	$20	$18.1K
D1208	Topical application of fluoride - excluding varnish	4	810	500	$10	$16K

Showing 1–10 of 17

Nearby Providers

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

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

Juan Rivera — Billing Profile & Reimbursement Data

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Juan Rivera — 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