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.

Ruben Diaz - Rodriguez (NPI 1629058482)

Key Findings

Field	Value
Entity Type	Individual
Organization	Ruben Diaz - Rodriguez
Address	Bayamon Medical Plaza
City	Bayamon
State	PR
ZIP	00959
Taxonomy	Pediatric Cardiology Physician
NPI Enumerated	January 18, 2006

Payer Source	Total Paid
Medicaid	$3.9M
Medicare	$0

This provider is effectively a Medicaid-only biller: there is no Medicare revenue on file while total Medicaid revenue is $3.9M, so payer exposure and reimbursement risk are concentrated in the Medicaid program rather than split across Medicare and Medicaid. That single-payer profile will materially shape contract negotiations and utilization benchmarking because comparisons to Medicare-based peers are not possible for this NPI.

Revenue concentration is extremely high: the precomputed top three Medicaid codes account for 88.2% of this provider’s total Medicaid revenue, with 93306 alone representing $2.8M (71.3% of Medicaid revenue). This level of concentration indicates the practice’s financial performance is heavily dependent on a small set of diagnostic services rather than a broad mix of procedure types.

Code mix and code descriptions identify a high-throughput pediatric cardiology imaging and outpatient evaluation operation: 93306 (echocardiography) is the dominant revenue driver, supported by high volumes of office E/M codes 99213 and 99203. The presence of ECG codes (93000, 93010) and stress testing (93015) in the top billing profile further supports that the practice’s workflow centers on cardiac diagnostic testing plus associated outpatient visits.

Competitive standing for the principal imaging code is extreme at the state level: 93306 ranks #3 of 213 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code). That ranking indicates the provider is a major regional source of echocardiography services relative to in-state peers and likely captures a substantial share of pediatric echo referrals.

The practice also shows unusually high new-patient evaluation volume: 99203 accounts for $311.7K (7.9% of Medicaid revenue) and ranks #22 of 1397 providers in-state (98th percentile; extreme outlier, far above typical state volume for this code). That pattern suggests a strong referral pipeline for new outpatient cardiology evaluations in the pediatric population rather than primarily follow-up visits.

Established-patient visits (99213) are a secondary revenue contributor at $352K (8.9% of Medicaid revenue) and rank #250 of 3229 providers in-state (92th percentile; typical, unremarkable volume for this code). The combination of high new-visit volume (99203) with typical established-visit ranking suggests capacity or scheduling emphasis on initial evaluations and diagnostic throughput instead of longitudinal chronic-care management.

Auxiliary cardiac diagnostics are also notable: 93000 (ECG with interpretation) generated $233K (5.9% of Medicaid revenue) and ranks #11 of 410 providers in-state (98th percentile; notably above typical state volume for this code), while 93015 (stress test interpretation) contributes $137.9K (3.5% of Medicaid revenue) and ranks #9 of 56 (85th percentile; typical, unremarkable volume). Together these codes imply the practice pairs imaging with physiologic testing and interpretation as part of a comprehensive pediatric cardiac diagnostic service line.

This NPI has been enumerated since 2006-01-18 (~20 years ago), indicating long tenure in the market; paired with the heavy echocardiography concentration and high new-patient volumes, the profile is consistent with an established pediatric cardiology practice that functions as a regional diagnostic hub within the state Medicaid population. Analysts should view future reimbursement or utilization shifts through the lens of concentrated dependency on a few diagnostic codes and the single-payer (Medicaid) revenue base.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	9,710	$290	$2.8M
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…	7,820	$50	$352K
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…	4,870	$60	$311.7K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	8,320	$30	$233K
93015	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	990	$140	$137.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	2,220	$20	$35.4K
99252	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the provider…	860	$30	$28.4K
99204	The 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	$140	$9.1K
99255	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…	210	$30	$7.1K
99241	Office consultation for a new or established patient, which requires these three key components: a problem focused history; a problem focused examination; and straightforward medical decision making.…	150	$50	$6.6K

Showing 1–10 of 12

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

Ruben Diaz - Rodriguez — 3 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	3	210	380	$210	$230.1K
93015	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	9	60	200	$110	$65.2K
93224	In this procedure, the provider applies an electrocardiographic, or ECG recorder, to a patient for up to 48 hours to detect abnormal heart rates and rhythms. He analyzes, compiles, and interprets the…	70	90	120	$110	$56.3K
99214	The provider sees an established 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…	712	900	360	$30	$42.5K
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…	250	3,230	330	$10	$42.4K
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…	22	1,400	160	$50	$29.6K
99204	The 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…	302	530	100	$70	$22.9K
99255	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…	29	70	120	$50	$21.8K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	11	410	390	$20	$21.7K
99252	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a straightforward level of medical decision making or the provider…	9	50	160	$30	$18.7K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ct Radiology Complex, LLC	PR	Diagnostic Radiology Physician	$0	$6.2M
Pk Industries Corp	PR	Oxygen Equipment & Supplies (DME)	$0	$3.3M
Doctors Center Hospital Bayamon Inc	PR	General Acute Care Hospital	$0	$3.1M
Laboratorios Clinico Bayamon Inc	PR	Clinical Medical Laboratory	$14K	$2.5M
Bayamon Medical Center Corp	PR	General Acute Care Hospital	$0	$2.3M
New Vision Medical Diagnostics Inc	PR	Clinical Medical Laboratory	$0	$1.9M
Centro De Patologia Avanzada De Pr Csp	PR	Clinical Pathology/Laboratory Medicine Physician	$0	$1.8M
Vitreo Retinal Consultants, Psc	PR	Specialist	$0	$1.5M
Stereotactic Breast Center Psc	PR	Ambulatory Surgical Clinic/Center	$0	$1.3M
Santiago Coste-sibilia	PR	Gastroenterology Physician	$4.2K	$1.3M

Ruben Diaz - Rodriguez — 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