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.

Aguadilla Eye Md Psc (NPI 1598997009)

Aguadilla Eye Md Psc is a ophthalmology physician provider located in Aguadilla, Puerto Rico. This profile covers 0 Medicare and 27 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Aguadilla Eye Md Psc
Address	13 Calle Mercedes Moreno
City	Aguadilla
State	PR
ZIP	00603
Taxonomy	Ophthalmology Physician
NPI Enumerated	August 17, 2009

Payer Source	Total Paid
Medicaid	$3.3M
Medicare	$0

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	6,100	$140	$842.2K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	13,230	$60	$754.1K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	440	$710	$313.7K
92201	The provider performs an extended ophthalmoscopy, typically with an indirect ophthalmoscope which utilizes a bright light and a hand–held indirect lens rather than the common hand–held one–piece…	6,610	$30	$211.4K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	4,230	$50	$190.5K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	7,290	$30	$189.6K
C9257	Injection, bevacizumab, 0.25 mg	5,590	$30	$184.4K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	6,890	$20	$165.2K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	1,430	$110	$153.4K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	150	$510	$77.5K

Showing 1–10 of 27

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

Aguadilla Eye Md Psc — 5 of 23 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	19	60	160	$380	$270.5K
67210	The provider destroys a lesion of the retina using a laser beam that heats up the tissue.	9	10	90	$370	$235.2K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	2	30	1,090	$130	$222.2K
67228	In retinopathy, tiny new vessels grow profusely and fibrous tissue proliferates in between the layers of the retina, which may extend into the optic nerve and vitreous, clear gel that fills the space…	6	10	110	$510	$153.3K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	11	350	540	$50	$96.4K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	21	120	180	$80	$62.9K
C9257	Injection, bevacizumab, 0.25 mg	2	20	350	$50	$61.8K
68761	The provider places a plug to close off the lacrimal punctum and block excessive drainage of tears. He performs this procedure to treat dry eye syndrome.	2	10	550	$140	$58.5K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	8	80	650	$20	$43.1K
92002	The provider performs an intermediate level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program.	13	440	370	$40	$38.5K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fidel De Frias Jimenez	PR	Anatomic Pathology & Clinical Pathology Physician	$5.5K	$3.3M
Hiram Ortega	PR	Gastroenterology Physician	$8.8K	$3.1M
Hiram Vera Arocho	PR	Dentist	$0	$2.7M
Clinica De Medicina Fisica Y Electrodiagnostico Inc.	PR	Physical Therapy Clinic/Center	$0	$1.4M
Laboratorio Clinico De Diego Corp	PR	Clinical Medical Laboratory	$13.7K	$1.1M
Gerardo Ortiz Hernandez	PR	General Practice Physician	$3K	$829.8K
Oscar F Cordero Of Dental Csp	PR	Dentist	$0	$800.5K
Dr. Nelson A. Mercado Castro, Csp	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$765.9K
Neurosleep Puerto Rico LLC	PR	Sleep Medicine (Psychiatry & Neurology) Physician	$0	$709K
Dr. Adriano Martinez Rivera - Cardiologo, C.s.p.	PR	Medical Specialty Clinic/Center	$0	$647.5K

Aguadilla Eye Md Psc — Billing Profile & Reimbursement Data

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Aguadilla Eye Md Psc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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