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NPI 1659380681 · San Juan, PR · Dermatopathology Physician
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Julio Sanchez-pont is a dermatopathology physician provider located in San Juan, Puerto Rico. This profile covers 5 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Julio Sanchez-pont |
| Address | 516b Calle Juan J Jimenez |
| City | San Juan |
| State | PR |
| ZIP | 00918 |
| Taxonomy | Dermatopathology Physician |
| NPI Enumerated | August 7, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $112.5K |
| Medicaid | $38.6K |
This provider is a dermatopathology-focused diagnostic practice: the code mix is dominated by surgical pathology reads and ancillary immunohistochemistry codes, with 88305 (level IV surgical pathology) the single largest line item and several immunostain interpretation codes (88341, 88342, 88312) appearing among top billings, which is consistent with a lab-based pathology workflow rather than procedural dermatology.
On Medicaid the provider is effectively single-code dependent: 88305 represents $38.5K and 100.0% of the provider's total Medicaid revenue (475 claims, $81 avg paid/claim), indicating Medicaid activity is almost entirely composed of level IV surgical pathology reads.
Payer mix leans toward Medicare at scale: Medicare revenue ($112.5K) noticeably exceeds Medicaid revenue ($38.6K), making Medicare the primary public payer for this provider and Medicaid a smaller, concentrated revenue stream.
Competitive standing is mixed across payers and codes: for Medicare 88305 ranks #2056 of 14580 nationally (86th percentile), showing above-median national volume for the core surgical pathology code, while supporting codes are modest—88341 ranks #7063 of 10274 (31st percentile) and 88304 ranks #1339 of 8796 (84th percentile), implying strength on core reads but limited national footprint on some ancillary services.
Tenure and continuity are long-standing: the NPI was enumerated on 2006-08-07 (~20 years ago), indicating an established practice history which aligns with a stable, interpretation-focused pathology service.
The revenue profile presents operational concentration risk: reliance on a single dominant code for Medicaid (88305 at 100.0% of Medicaid revenue) and very high concentration across the top three Medicare codes (94.9%) suggests sensitivity to changes in referral patterns, test mix, or reimbursement for those few services given the lack of revenue diversification.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 1,680 | $60 | $94.3K |
| 88341 | The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified… | 130 | $70 | $9.1K |
| 88304 | The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 120 | $30 | $4.1K |
| 88342 | The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,… | 40 | $80 | $3.3K |
| 88312 | The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets… | 30 | $90 | $2.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 480 | $80 | $38.5K |
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 29 | 30 | 4,250 | $80 | $1.3M |
Other providers in the same ZIP code as Julio Sanchez-pont, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Laboratorio De Patologia Dr Noy | PR | Anatomic Pathology Physician | $0 | $45.7M |
| Hato Rey Pathology Associates Inc | PR | Clinical Medical Laboratory | $58.5K | $42M |
| Home Orthopedics Corp | PR | Prosthetic/Orthotic Supplier | $0 | $20.7M |
| Orthobone, Inc | PR | Customized Equipment (DME) | $0 | $15.5M |
| Smith & Nephew Inc. | PR | Prosthetic/Orthotic Supplier | $0 | $12M |
| Laboratorio Clinico Noy Inc | PR | Clinical Medical Laboratory | $76.1K | $9.9M |
| Servicios Radiologicos Asociados Jorge Perez Brais | PR | Diagnostic Radiology Physician | $0 | $2.9M |
| Luis Torres Vera | PR | Allergy Physician | $21.5K | $2.7M |
| Inspira Psychiatric Services Psc | PR | Adult Mental Health Clinic/Center | $0 | $2.5M |
| Frankie Alvarado | PR | Pulmonary Disease Physician | $7.3K | $2.4M |
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