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.

Home Orthopedics Corp (NPI 1578560447)

Field	Value
Entity Type	Organization
Organization	Home Orthopedics Corp
Address	202 Calle Federico Costa
City	San Juan
State	PR
ZIP	00918
Taxonomy	Prosthetic/Orthotic Supplier
NPI Enumerated	July 6, 2005

Payer Source	Total Paid
Medicaid	$20.7M
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file and lifetime Medicaid revenue is $20.7M. The absence of Medicare activity indicates the organization’s patient and payer mix is concentrated in state Medicaid programs rather than federal fee-for-service Medicare flows.

Revenue is highly concentrated in a single code grouping: the precomputed top three Medicaid codes account for 99.5% of this provider’s Medicaid revenue, with L8699 alone representing 98.9% of Medicaid revenue. That concentration implies the provider’s financial performance is closely tied to reimbursement and utilization trends for a single prosthetic implant code.

L8699 defines the business profile: the provider reported 6.8K claims for L8699 at $2987 avg paid/claim for $20.4M revenue, indicating the operation is primarily supplying prosthetic implants (prosthetic implant, not otherwise specified). The high claim volume combined with a relatively large avg paid/claim is consistent with a high-throughput prosthetic implant supplier rather than a low-volume boutique orthotics shop.

The remainder of billed services are small in comparison and skew toward orthotic/add-on and diabetic footwear codes: L5673 (116 claims, $738 avg paid/claim, $85.6K revenue), A5500 (836 claims, $45 avg paid/claim, $37.6K revenue), and A5512 (654 claims, $52 avg paid/claim, $34K revenue) together make up the remaining share of revenue among the top codes. These line items show the provider also offers lower-extremity orthotic additions and diabetic footwear, but those services are marginal to overall revenue.

State-level competitive standing is dominant for the main revenue driver: L8699 ranks #1 of 23 providers in-state and is in the 100th percentile, described as notably above typical state volume for this code. Several other codes also show top-in-state ranks (many #1 of small provider pools), but those ranks reflect modest absolute revenue compared to L8699.

The payer concentration and code concentration together create operational sensitivity: because nearly all revenue flows through Medicaid and almost entirely through L8699 (98.9% of Medicaid revenue), changes in state Medicaid policy, reimbursement, or utilization for prosthetic implants could materially affect revenue. The lack of Medicare billing removes a potential revenue diversification channel.

The provider shows scale and longevity in the market: NPI enumeration date 2005-07-06 (~21 years ago) indicates a long-tenured presence in the state Medicaid market, which aligns with the high cumulative volume observed for L8699. Long tenure plus dominant state ranking for the primary code suggests established contracting or referral positioning within the Medicaid ecosystem.

There is a clear dichotomy in average paid per claim across services that highlights product mix: the core L8699 activity has a high avg paid/claim ($2987) and very large aggregate revenue ($20.4M), whereas diabetic shoe items such as A5500 ($45 avg paid/claim) and A5512 ($52 avg paid/claim) produce meaningful claim counts but negligible revenue impact. This demonstrates the business is anchored by high-value prosthetic implants with supplemental lower-value orthotic/footwear offerings.

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
L8699	Prosthetic implant, not otherwise specified	6,840	$2,990	$20.4M
L5673	Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or…	120	$740	$85.6K
A5500	For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe	840	$50	$37.6K
L5671	Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert	70	$490	$35.9K
A5512	For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base…	650	$50	$34K
L8420	Prosthetic sock, multiple ply, below knee, each	90	$210	$18.1K
L8030	Breast prosthesis, silicone or equal, without integral adhesive	20	$290	$6.9K
L8000	Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type	30	$220	$5.7K
L2820	Addition to lower extremity orthosis, soft interface for molded plastic, below knee section	10	$320	$4.2K
L5962	Addition, endoskeletal system, below knee, flexible protective outer surface covering system	10	$120	$1.6K

Showing 1–10 of 11

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

Home Orthopedics Corp — 5 of 11 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
L8699	Prosthetic implant, not otherwise specified	1	20	740	$2,660	$4.6M
A5512	For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base…	1	10	530	$80	$43.2K
A5500	For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe	1	10	620	$70	$41.2K
L5673	Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or…	1	10	50	$650	$40.5K
L5671	Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert	1	10	50	$470	$24.7K
L8420	Prosthetic sock, multiple ply, below knee, each	2	10	70	$230	$14.1K
L5962	Addition, endoskeletal system, below knee, flexible protective outer surface covering system	2	10	20	$410	$8.2K
L8030	Breast prosthesis, silicone or equal, without integral adhesive	1	10	20	$290	$6.9K
L8000	Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type	1	10	30	$220	$5.7K
L2820	Addition to lower extremity orthosis, soft interface for molded plastic, below knee section	1	10	10	$320	$4.2K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Home Orthopedics Corp, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio De Patologia Dr Noy	PR	Anatomic Pathology Physician	$0	$45.7M
Hato Rey Pathology Associates Inc	PR	Clinical Medical Laboratory	$58.5K	$42M
Orthobone, Inc	PR	Customized Equipment (DME)	$0	$15.5M
Smith & Nephew Inc.	PR	Prosthetic/Orthotic Supplier	$0	$12M
Laboratorio Clinico Noy Inc	PR	Clinical Medical Laboratory	$76.1K	$9.9M
Servicios Radiologicos Asociados Jorge Perez Brais	PR	Diagnostic Radiology Physician	$0	$2.9M
Luis Torres Vera	PR	Allergy Physician	$21.5K	$2.7M
Inspira Psychiatric Services Psc	PR	Adult Mental Health Clinic/Center	$0	$2.5M
Frankie Alvarado	PR	Pulmonary Disease Physician	$7.3K	$2.4M
Boston Scientific Del Caribe, Inc	PR	Durable Medical Equipment & Medical Supplies	$0	$2.2M

Home Orthopedics Corp — 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