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.

Caribbean Cancer Care Services, LLC (NPI 1679900567)

Field	Value
Entity Type	Organization
Organization	Caribbean Cancer Care Services, LLC
Address	2225 Ponce By Pass
City	Ponce
State	PR
ZIP	00717
Taxonomy	Medical Oncology Physician
NPI Enumerated	October 9, 2013

Payer Source	Total Paid
Medicaid	$6.5M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and therefore operates, in effect, as a Medicaid-focused practice with $6.5M in lifetime Medicaid revenue. The absence of Medicare activity makes the Medicaid business line the primary — and essentially sole — source of billed revenue in our dataset for this NPI.

Revenue is highly concentrated: the precomputed top-three Medicaid codes (Q0084, 96367, 99213) together account for 57.3% of the provider’s total Medicaid revenue. Individually, Q0084 accounts for 26.8%, 96367 for 20.7%, and 99213 for 9.8% of Medicaid revenue, signaling a narrow set of services driving the majority of receipts.

The CPT/HCPCS mix points to a high-throughput oncology infusion operation: Q0084 (chemotherapy administration by infusion), 96365/96366/96367 (initial and additional IV infusion codes), and 96413/96415 (chemotherapy administration and additional-hour add-ons) dominate the revenue picture. The presence of both primary infusion codes and multiple add-on infusion hours indicates sessions with multiple agents or extended infusion times consistent with an infusion center-style practice rather than episodic office encounters.

On state-level competitive standing, this provider is a clear leader for infusion administration codes: Q0084 ranks #1 of 74 providers (100th percentile; labeled an extreme outlier) and 96367 ranks #1 of 46 providers (100th percentile; extreme outlier). Those top ranks indicate the provider is a dominant Medicaid supplier of chemotherapy infusion services in Puerto Rico.

Several infusion- and support-drug codes are statistical outliers, reinforcing the specialization: 96365 ranks #2 of 63 (98th percentile; extreme outlier), 96366 ranks #1 of 22 (100th percentile; extreme outlier), and J1100 ranks #1 of 34 (100th percentile; extreme outlier). These labels suggest throughput and drug-administration patterns that are far above typical state volumes for those specific items.

Office evaluation-and-management activity supports continuity oncology care rather than being the main revenue driver: 99213 represents $634.6K (9.8% of Medicaid revenue) and ranks #162 of 3229 providers (95th percentile; described as typical), while 99204 contributes $150.1K (2.3%) and ranks #19 of 525 (97th percentile; notably above typical). This mix is consistent with frequent established-patient follow-ups accompanying a high-volume infusion practice.

Revenue from administered medications and supportive agents is meaningful but secondary to infusion services: J1453 ($294.1K, 4.5% of Medicaid revenue) ranks #1 of 7 providers and J1626 ($212.4K, 3.3%) ranks #1 of 2 providers, while a range of low-unit-value injections (J1200, J2405, S0028) reflect high claim counts for supportive meds. Together these codes show the practice captures both reimbursement for infusion procedures and for commonly co-administered oncology support drugs.

The NPI was enumerated on 2013-10-09 (~13 years ago), indicating an established presence in PONCE, PR; coupled with the provider’s dominant state ranks on core infusion codes, this suggests sustained specialization in Medicaid-funded chemotherapy services. Given the heavy concentration in a small set of infusion-centered codes and the lack of Medicare volume, the provider’s financial profile is highly dependent on Medicaid reimbursement and infusion-utilization patterns.

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
Q0084	Chemotherapy administration by infusion technique only, per visit	20,720	$80	$1.7M
96367	The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose…	18,440	$70	$1.3M
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…	12,950	$50	$634.5K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	12,000	$40	$515.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	5,130	$90	$456.7K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	12,610	$30	$428.6K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	4,860	$90	$418K
J1453	Injection, fosaprepitant, 1 mg	1,350	$220	$294.1K
J1626	Injection, granisetron hydrochloride, 100 mcg	14,160	$20	$212.4K
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…	1,460	$100	$150.1K

Showing 1–10 of 29

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

Caribbean Cancer Care Services, LLC — 11 of 25 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
Q0084	Chemotherapy administration by infusion technique only, per visit	1	70	900	$80	$219.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	2	60	240	$100	$147.6K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	8	70	750	$80	$138K
J1626	Injection, granisetron hydrochloride, 100 mcg	1	10	7,810	$10	$110.4K
Q0081	Infusion therapy, using other than chemotherapeutic drugs, per visit	4	10	560	$70	$106.3K
J1453	Injection, fosaprepitant, 1 mg	1	10	190	$170	$96.4K
96415	In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the…	6	60	360	$80	$94K
96367	The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose…	1	50	520	$50	$82.4K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	1	20	350	$30	$50.5K
96417	In this add–on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report administration of a different chemotherapy…	7	30	440	$60	$42.4K

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with Caribbean Cancer Care Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rolando Jimenez	PR	Hematology & Oncology Physician	$784K	$0

Nearby Providers

Other providers in the same ZIP code as Caribbean Cancer Care Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Caribbean Imaging And Radiation Treatment Center,inc	PR	Multi-Specialty Clinic/Center	$0	$19.3M
Compression Health Care Inc	PR	Oxygen Equipment & Supplies (DME)	$0	$10.6M
Oficina Medica Dr Quintero Psc	PR	Specialist	$0	$4.9M
Pet Diagnostic Imaging Corp	PR	Radiology Clinic/Center	$0	$4.8M
Hector Velez Cortes	PR	Hematology & Oncology Physician	$4.3K	$4M
Centro Oncologico De La Mujer De Puerto Rico Csp	PR	Oncology Clinic/Center	$0	$3.8M
Caribbean Wellness Oncology, Psc	PR	Hematology & Oncology Physician	$0	$3.6M
Jose Santiago Alvarado	PR	Anatomic Pathology & Clinical Pathology Physician	$17.2K	$3.2M
Dr German Chaves Radiologo Csp	PR	Diagnostic Radiology Physician	$0	$2.9M
Lydia Irizarry Gonzalez	PR	Pediatric Endocrinology Physician	$0	$2.6M

Caribbean Cancer Care Services, LLC — Billing Profile & Reimbursement Data

Sign up for Caribbean Cancer Care Services, LLC — Billing Profile & Reimbursement Data policy alerts

Caribbean Cancer Care Services, LLC — Billing Profile & Reimbursement Data

Sign up for Caribbean Cancer Care Services, LLC — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References