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 Unspecified Location for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Unspecified Location 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. Unspecified Location (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.

Rehabilitacion Cmd (NPI 1588836159)

Key Findings

Field	Value
Entity Type	Organization
Organization	Rehabilitacion Cmd
Address	Calle Del Parque 110
City	Santurce
State	ZZ (Unspecified Location)
ZIP	00911
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	March 24, 2008

Payer Source	Total Paid
Medicaid	$270K
Medicare	$0

REHABILITACION CMD is effectively a single‑payer Medicaid provider: there is no Medicare billing on file and all recorded lifetime revenue is Medicaid at $270K. This profile should be interpreted as Medicaid‑centric services rather than a mixed Medicare/Medicaid outpatient operation.

Revenue is highly concentrated in a small set of therapy codes: the precomputed top three Medicaid codes (97032, 97035, 97530) account for 66.1% of the provider’s total Medicaid revenue. Individually those codes generated $64.7K (97032, 24.0%), $63K (97035, 23.3%), and $50.8K (97530, 18.8%), reflecting that a few high‑volume therapy codes drive the majority of income.

The code mix identifies REHABILITACION CMD as a rehabilitation/physical therapy clinic focused on hands‑on and modality‑based therapy services: large volumes of 97032 (5K claims, $13 avg paid/claim), 97035 (4.8K claims, $13 avg paid/claim), 97530 (5.1K claims, $10 avg paid/claim), plus 97010 and 97124, point to routine electrical stimulation, therapeutic modalities, functional activity sessions, hot/cold packs, and massage as core services. These procedure codes imply the operation emphasizes high‑frequency therapy encounters rather than high‑acuity medical management.

Utilization is high‑frequency, low‑unit‑value: major therapy CPTs show multi‑thousand claim counts with low average payments per claim (typical averages $10–$13), indicating revenue is generated by volume of repeat therapy visits rather than high single‑visit reimbursements. Additionally, several G‑codes and outcome‑measurement codes are billed in large counts (for example, G8539 and G8730) but report $0 revenue, suggesting documentation of functional outcomes and pain assessment is routine but not separately paid.

State competitive standing is mixed but constrained by a very small peer set: REHABILITACION CMD ranks #1 of 1 providers in‑state for many therapy and outcome codes (several entries noted as 0th percentile with no state peer volume comparison available), and it ranks #1 of 2 providers for codes such as 97530 and 97010 at the 100th percentile. In plain terms, the provider appears to be the sole Medicaid biller in the available dataset for many rehab codes and a leading biller where there are only one other state peer, but the tiny peer universe limits broader market inference.

Clinical breadth includes evaluation and E/M activity in addition to therapy: codes 97161 (344 claims, $15 avg paid/claim), 97164 (54 claims, $22 avg paid/claim), 99213 (691 claims, $19 avg paid/claim), and 99203 (501 claims, $15 avg paid/claim) indicate the facility performs initial and follow‑up physical therapy evaluations and some office/outpatient E/M visits alongside modality and treatment sessions. These evaluation and E/M services contribute modestly to revenue (e.g., 99213 accounted for $13.1K, 4.9% of Medicaid revenue) and support a structured therapy care pathway.

The provider is long‑enumerated with an NPI date of 2008-03-24 (~18 years ago), indicating an established presence in the claims data; combined with concentrated therapy volumes, this suggests a stable, specialization‑oriented rehabilitation practice serving Medicaid beneficiaries over many years.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97032	Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…	4,970	$10	$64.7K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	4,850	$10	$63K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	5,080	$10	$50.8K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	3,490	$10	$34.9K
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	4,940	$10	$29.7K
99213	The 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…	690	$20	$13.1K
99203	The 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…	500	$20	$7.5K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	340	$20	$5.2K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	50	$20	$1.2K
G8420	Bmi is documented within normal parameters and no follow-up plan is required	180	$0	$0

Showing 1–10 of 16

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Unspecified Location providers billing the same CPT/HCPCS codes. Note: "ZZ" is a placeholder CMS uses when a provider's practice-location state wasn't reported — not a traditional US state; claims coded under it are benchmarked here as their own state-equivalent group.

Claims Volume vs. Unspecified Location Distribution

Rehabilitacion Cmd — 3 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Unspecified Location

Full comparison — all codes billed, vs. Unspecified Location median

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97032	Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…	1	10	4,970	$10	$64.7K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	1	10	4,850	$10	$63.2K
97124	Generally, massage is a technique of applying light or firm pressure, with different movement styles, using palms, fingers, and thumbs, over body muscles and tissues in order to restore better blood…	1	10	4,940	$10	$28.6K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	1	10	2,550	$10	$25K
97010	The provider, such as physical therapist, applies a hot or cold pack to a specific body site to treat an injury or disease.	1	10	1,780	$10	$17.3K
99203	The 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	10	500	$10	$7.5K
99213	The 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…	1	10	370	$20	$7.3K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	1	10	340	$20	$5.2K
97164	The provider, typically a physical therapist, conducts a physical therapy re–evaluation that includes history review and standardized tests and measures to assess body structure and function; she…	1	10	50	$20	$1.2K
G8420	Bmi is documented within normal parameters and no follow-up plan is required	1	10	180	$0	$0

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rad One, Psc	PR	Diagnostic Radiology Physician	$0	$2M
Walgreen Co	PR	Pharmacy	$70.7K	$0
Gabriel Acosta Gonzalez	PR	Anatomic Pathology & Clinical Pathology Physician	$49.1K	$0
Victor Vargas	PR	Specialist	$30.6K	$0
Manuel Rivero Iturregui	PR	Anatomic Pathology & Clinical Pathology Physician	$24.3K	$0
Victor Carlo-chevere	PR	Anatomic Pathology & Clinical Pathology Physician	$13.5K	$0
Francisco Gomez Goytia	PR	Diagnostic Radiology Physician	$8K	$0

Rehabilitacion Cmd — Billing Profile & Reimbursement Data

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Rehabilitacion Cmd — 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