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.

Inspira Behavioral Care Corp. (NPI 1609381524)

Field	Value
Entity Type	Organization
Organization	Inspira Behavioral Care Corp.
Address	Calle 2 Km 11.8
City	Bayamon
State	PR
ZIP	00961
Taxonomy	Psychiatric Hospital
NPI Enumerated	December 14, 2017

Payer Source	Total Paid
Medicaid	$742.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99441	N/A	6,210	$30	$186.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	1,430	$100	$141.7K
99442	N/A	2,200	$50	$118.7K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,690	$50	$81.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,410	$40	$60.7K
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…	990	$60	$60.1K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	1,480	$30	$38.4K
99347	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at…	340	$50	$18.4K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	110	$140	$15.5K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	4,780	$1	$14.3K

Showing 1–10 of 14

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

Inspira Behavioral Care Corp. — 0 of 14 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1,126	3,230	330	$10	$42.4K
98968	A nonphysician qualified healthcare professional discusses, via telephone, a health issue and possible treatment or management with an established patient, parent, or guardian. This service includes…	9	30	150	$10	$24.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	84	320	470	$10	$20K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	239	840	340	$1	$16.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	50	90	170	$10	$15.1K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	40	70	120	$10	$9.9K
99442	N/A	75	450	130	$10	$9K
99347	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves straightforward medical decision making or the provider spends at…	26	50	300	$10	$7.9K
99441	N/A	70	480	400	$1	$7.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	19	360	80	$10	$6.4K

Showing 1–10 of 14

Related Providers

Other providers that share a Tax Identification Number (TIN) with Inspira Behavioral Care Corp., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$1.7M
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$1.1M
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$1M
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$789.3K

Nearby Providers

Other providers in the same ZIP code as Inspira Behavioral Care Corp., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nazareno Enterprises And Services LLC	PR	Prosthetic/Orthotic Supplier	$0	$23.8M
Cdt Gmsp, Inc	PR	Federally Qualified Health Center (FQHC)	$0	$4.6M
Centro Medico Del Turabo, Inc.	PR	Home Infusion Therapy Pharmacy	$0	$3.9M
Djm Imaging Center LLC	PR	Radiology Clinic/Center	$0	$3.6M
Cdt Centro De Servicios Medicos Integrados Inc.	PR	Clinical Medical Laboratory	$0	$2.3M
Cdt G.m,s.p., Inc Radiologia	PR	Federally Qualified Health Center (FQHC)	$0	$1.7M
Pro-health Clinical Services LLC	PR	Endocrinology, Diabetes & Metabolism Physician	$0	$1.6M
Edilberto Martinez	PR	Maternal & Fetal Medicine Physician	$0	$1.4M
Laboratorio Teresita	PR	Clinical Medical Laboratory	$4.8K	$1.3M
Dr Joaquin Balaguer Group Psc	PR	Podiatrist	$0	$1.2M

Inspira Behavioral Care Corp. — Billing Profile & Reimbursement Data

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Inspira Behavioral Care Corp. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References