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.

Sociedad De Servicios Neonatales De Arecibo (NPI 1609958446)

Field	Value
Entity Type	Organization
Organization	Sociedad De Servicios Neonatales De Arecibo
Address	Avenida San Luis Carr 129 Km1
City	Arecibo
State	PR
ZIP	00612
Taxonomy	Neonatal-Perinatal Medicine Physician
NPI Enumerated	October 20, 2006
NPI Deactivated	July 17, 2007

Payer Source	Total Paid
Medicaid	$14.3M
Medicare	$0

Key Findings

SOCIEDAD DE SERVICIOS NEONATALES DE ARECIBO reports $14.3M in lifetime Medicaid revenue and has no Medicare billing on file, making its public payer footprint effectively single-payer (Medicaid) in available data. This concentration on Medicaid means national Medicare comparisons are not possible from the claims on file.

Revenue is highly concentrated in a small set of neonatal-care codes: the precomputed top three Medicaid codes account for 89.7% of this provider’s total Medicaid revenue. Those top three are 99469 ($10.7M, 74.3% of Medicaid revenue), 99468 ($1.5M, 10.2%), and 99460 ($758K, 5.3%), indicating most dollars flow from intensive newborn evaluation and immediate postnatal services.

The code mix (dominant use of 99469 and 99468 alongside high volumes of 99460, 99462, and 99464) indicates the provider operates as a neonatal-perinatal service with substantial activity in neonatal critical care, initial and subsequent evaluations of newborns, routine newborn hospital care, and presence at deliveries for anticipated complications. This pattern is consistent with a NICU-focused consultative practice embedded in hospital perinatal services rather than outpatient pediatric primary care.

Competitive standing within Puerto Rico is strong for multiple newborn-service codes: the provider ranks #1 of 4 for 99468 and #1 of 24 for 99460 (both at the 100th percentile), and #1 of 7 for 99464 (100th percentile), while ranking #2 of 6 for 99469 (80th percentile) and #2 of 26 for 99462 (96th percentile). These rankings show the organization is a leading statewide provider for many newborn evaluation and delivery-attendance services, with some codes at or near dominant market positions.

Several codes are flagged as statistical outliers or notably above typical state volume: 99460 is labeled an "extreme outlier" in the state, while 99462 and 99464 are "notably above typical" volumes. In contrast, 99469 and 99468 are described as "typical, unremarkable" volumes relative to peers, so the provider combines both exceptionally high-volume routine-newborn services and more typical critical-care billing for some neonatal evaluations.

Claim counts and average payments illustrate the operational mix: large claim volumes for routine newborn follow-ups and subsequent hospital newborn care (e.g., 99462 at 22K claims with $34 avg paid/claim; 99460 at 10.5K claims with $72 avg paid/claim) coexist with fewer, high-paid claims for neonatal critical-care follow-up (99469 at 3.3K claims with $3245 avg paid/claim and 99468 at 3.1K claims with $472 avg paid/claim). This combination drives revenue concentration toward high-dollar critical-care codes while workload is dominated by high-count, lower-paid routine newborn services.

The provider performs inpatient discharge day management as part of its hospital workstream: 99238 generated $275K (1.9% of Medicaid revenue), with a rank of #14 of 246 in-state at the 95th percentile, suggesting meaningful participation in inpatient throughput and discharge care in addition to neonatal consultative services.

The NPI was enumerated on 2006-10-20 (~20 years ago), indicating long tenure in the market; combined with the heavy Medicaid concentration and leading state ranks for several neonatal codes, payers and health systems should view this entity as an established, Medicaid-focused neonatal specialty provider whose contracting and network placement will materially affect newborn and NICU capacity in the area.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	3,280	$3,250	$10.7M
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	3,090	$470	$1.5M
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	10,530	$70	$758K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	21,990	$30	$747.7K
99464	The provider is present during the delivery, at the request of the delivering provider, and during the basic stabilization of the newborn immediately after birth, typically when fetal distress or…	6,300	$70	$447.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	2,990	$90	$275K

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

Sociedad De Servicios Neonatales De Arecibo — 4 of 6 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	2	10	740	$1,410	$2.9M
99468	The provider evaluates and manages the initial care of a newborn or infant less than 28 days of age in a neonatal critical care setting.	1	10	590	$500	$535.1K
99464	The provider is present during the delivery, at the request of the delivering provider, and during the basic stabilization of the newborn immediately after birth, typically when fetal distress or…	1	10	1,460	$70	$144.1K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	2	30	250	$40	$108.9K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	1	20	210	$70	$98.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	14	250	180	$30	$23.1K

Nearby Providers

Other providers in the same ZIP code as Sociedad De Servicios Neonatales De Arecibo, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Toledo, LLC	PR	Clinical Medical Laboratory	$83.2K	$11.9M
Metro Pavia At Home, LLC	PR	Home Health Agency	$0	$6.6M
Hospicio La Paz Inc	PR	Community Based Hospice Care Agency	$0	$5.7M
Retina Care Psc	PR	Ophthalmology Physician	$0	$4.3M
Integral Therapy Center	PR	Hearing and Speech Clinic/Center	$0	$3.8M
Luis Montalvo	PR	Ophthalmology Physician	$8K	$3.5M
Laboratorio Clinico Villa Los Santos	PR	Clinical Medical Laboratory	$360	$3.1M
Emergency Physician Providers, LLC	PR	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.8M
Arraiza Radiology Psc	PR	Diagnostic Radiology Physician	$0	$2.8M
Instituto Del Cancer Y Enfermedades De La Sangre, Csp	PR	Hematology & Oncology Physician	$0	$2.8M

Sociedad De Servicios Neonatales De Arecibo — Billing Profile & Reimbursement Data

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Sociedad De Servicios Neonatales De Arecibo — 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