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.

St Gianna Pediatrics (NPI 1649546136)

Field	Value
Entity Type	Organization
Organization	St Gianna Pediatrics
Address	312 Ave De Diego
City	San Juan
State	PR
ZIP	00909
Taxonomy	Pediatrics Physician
NPI Enumerated	March 28, 2012

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,080	$230	$705.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,790	$90	$250.7K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	6,080	$30	$176.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	1,030	$50	$47.4K
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	580	$60	$35.8K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	590	$60	$34.7K
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.…	1,210	$20	$21.8K
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…	50	$10	$570

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

St Gianna Pediatrics — 2 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99462	The provider performs the evaluation and management of a normal newborn on a day subsequent to the initial hospital evaluation.	10	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.	7	20	210	$70	$98.8K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	16	340	210	$70	$81.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	120	500	220	$40	$79.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	38	460	200	$50	$60.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8	320	100	$80	$31.3K
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…	178	250	180	$30	$23.1K
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.…	15	100	180	$30	$18.4K

Nearby Providers

Other providers in the same ZIP code as St Gianna Pediatrics, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Best Option Healthcare Puerto Rico LLC	PR	Home Infusion Therapy Pharmacy	$0	$41.5M
Vita Healthcare Inc	PR	Home Health Agency	$0	$9.4M
Eladio Perez Cruz	PR	Gastroenterology Physician	$2.1K	$2.5M
Felix Lugo-adams	PR	Interventional Cardiology Physician	$3.7K	$1.9M
Farmacia San Rafael Santurce, Inc	PR	Community/Retail Pharmacy	$0	$1.5M
Lauren Lynch	PR	Maternal & Fetal Medicine Physician	$0	$1.4M
Jaime Ruiz-rodriguez	PR	Cardiovascular Disease Physician	$17.7K	$1.2M
Empresas Alvaro Torres	PR	Speech-Language Pathologist	$0	$1.1M
Best Option Healthcare Puerto Rico LLC	PR	Home Health Agency	$0	$1.1M
Ag Thyroid & Endocrine Clinic LLC	PR	Endocrinology, Diabetes & Metabolism Physician	$0	$983.2K

St Gianna Pediatrics — Billing Profile & Reimbursement Data

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St Gianna Pediatrics — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References