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    OpenPayerNPI Medicare & MedicaidMarco Perez Toro
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    Marco Perez Toro — Billing Profile & Reimbursement Data

    NPI 1578733937 · Bayamon, PR · Pain Medicine (Physical Medicine & Rehabilitation) Physician

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    Marco Perez Toro is a pain medicine (physical medicine & rehabilitation) physician provider located in Bayamon, Puerto Rico. This profile covers 7 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMarco Perez Toro
    Address64 Calle Santa Cruz
    CityBayamon
    StatePR
    ZIP00961
    TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
    NPI EnumeratedMarch 1, 2008

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

    Payer SourceTotal Paid
    Medicare$45.9K
    Medicaid$2.1K

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    7 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…240$70$15.9K
    64483This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection into a single level (either lumbar or sacral).40$210$7.8K
    99204The provider sees a new 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 provider…70$120$7.5K
    64493The provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that joint, using imaging guidance…40$160$6.4K
    64494In this add–on procedure, the provider injects a diagnostic or therapeutic substance into a single lumbar or sacral paravertebral facet (zygapophyseal) joint, or into the nerves that supply that…40$80$3.1K
    27096The provider performs an injection in the joint between the sacrum and ilium on one side of the body, with the aid of imaging equipment to locate the injection site. He injects an anesthetic to…20$130$2.7K
    64484This procedure is the injection of an anesthetic agent and/or steroid in the form of a transforaminal epidural injection in the lumbar or sacral region. The code applies to each additional level…30$90$2.5K

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    7 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    6448341030$170$9.3K
    99213591,53050$60$4.2K
    6448461030$80$4.1K
    6449331040$130$4K
    99204620020$110$2.7K
    6449431040$70$2.1K
    2709611020$110$1.9K

    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.

    1 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…30$70$2.1K

    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

    1 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    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…2,7223,230330$10$42.4K

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Marco Perez Toro, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Jean Gallardo VarelaPRPain Medicine Physician$19.8K$8.4K
    Alejandro Porrata NievaPRInterventional Pain Medicine Physician$24.1K$0

    Nearby Providers

    Other providers in the same ZIP code as Marco Perez Toro, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Nazareno Enterprises And Services LLCPRProsthetic/Orthotic Supplier$0$23.8M
    Cdt Gmsp, IncPRFederally Qualified Health Center (FQHC)$0$4.6M
    Centro Medico Del Turabo, Inc.PRHome Infusion Therapy Pharmacy$0$3.9M
    Djm Imaging Center LLCPRRadiology Clinic/Center$0$3.6M
    Cdt Centro De Servicios Medicos Integrados Inc.PRClinical Medical Laboratory$0$2.3M
    Cdt G.m,s.p., Inc RadiologiaPRFederally Qualified Health Center (FQHC)$0$1.7M
    Pro-health Clinical Services LLCPREndocrinology, Diabetes & Metabolism Physician$0$1.6M
    Edilberto MartinezPRMaternal & Fetal Medicine Physician$0$1.4M
    Laboratorio TeresitaPRClinical Medical Laboratory$4.8K$1.3M
    Dr Joaquin Balaguer Group PscPRPodiatrist$0$1.2M

    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.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Puerto Rico Distribution
    Marco Perez Toro — 2 of 7 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico
    Medicaid Revenue by Year vs. Puerto Rico Providers
    0 of 1 year billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    Marco Perez Toro — 0 of 1 code billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico