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.

Grupo Medico Cesmi (NPI 1659496776)

Grupo Medico Cesmi is a clinic/center provider located in Bayamon, Puerto Rico. This profile covers 0 Medicare and 74 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Grupo Medico Cesmi
Address	59 Calle Santa Cruz
City	Bayamon
State	PR
ZIP	00961
Taxonomy	Clinic/Center
NPI Enumerated	March 20, 2007

Payer Source	Total Paid
Medicaid	$621.9K
Medicare	$0

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

74 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	1,810	$80	$146.3K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	1,010	$70	$71.9K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	890	$80	$67.7K
72100	The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays…	1,760	$30	$45.7K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	1,340	$30	$42.9K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	2,270	$20	$40.9K
97802	The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…	750	$50	$39.9K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	640	$60	$35.7K
72040	The patient has a 2– or 3–view X–ray of the neck vertebrae.	1,140	$30	$30.9K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	1,320	$20	$30.3K

Showing 1–10 of 74

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

Grupo Medico Cesmi — 0 of 21 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

74 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	103	180	890	$70	$145.5K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	45	230	510	$60	$61K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	748	810	2,350	$10	$52.7K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	97	220	290	$60	$47.2K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	41	170	310	$60	$46.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	168	280	210	$30	$43.8K
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…	140	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…	42	3,230	330	$10	$42.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	806	850	3,250	$10	$40.5K
93970	The provider performs an ultrasound scanning procedure called a duplex scan to characterize the pattern and direction of blood flow in extremity veins (arms or legs). This is a complete, bilateral…	58	70	80	$110	$37.4K

Showing 1–10 of 74

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

Grupo Medico Cesmi — Billing Profile & Reimbursement Data

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Grupo Medico Cesmi — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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