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.

Jose Diaz-abascal (NPI 1689786170)

Field	Value
Entity Type	Individual
Organization	Jose Diaz-abascal
Address	A 1 Munoz Rivera Suite 302
City	Caguas
State	PR
ZIP	00726
Taxonomy	Oral and Maxillofacial Surgery (Dentist)
NPI Enumerated	August 31, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and reports $3.8M in lifetime Medicaid revenue, making Medicaid effectively the sole payer driving this practice’s billed activity. The absence of Medicare volume indicates the profile and financial performance should be evaluated primarily through Medicaid utilization and reimbursement patterns.

Revenue is highly concentrated in a small set of Medicaid codes: the top three codes account for 64.0% of this provider’s total Medicaid revenue. Specifically, D7240 generated $1.1M (28.3%), D7210 generated $860.4K (22.5%), and D9223 generated $504.9K (13.2%), so a handful of services dominate the revenue mix.

The code mix strongly points to an oral/maxillofacial surgery practice focused on surgical extractions and associated procedures. The presence of high-volume extraction codes such as D7210 (description: extraction, erupted tooth requiring removal of bone and/or sectioning of tooth) alongside other surgical codes (D7230, D7220, D7240) and sedation/anesthesia codes (D9223, D9222) suggests a clinic model built around operative tooth removal with sedation support and related imaging/evaluation work.

On state-level competitive standing, this provider is a major participant for several high-volume Medicaid codes. D7210 ranks #2 of 99 providers in-state and is marked as an "extreme outlier" (99th percentile), D9223 ranks #2 of 37 (97th percentile, notably above typical state volume), and D7240 ranks #4 of 26 (88th percentile, notably above typical state volume), indicating market dominance for specific oral surgery services.

Claim counts and throughput metrics reinforce a high-volume surgical practice: the file shows 10.8K claims for D7210, 6.2K claims for D7240, 5.4K claims for D9223, and 8.2K claims for D0160. These large claim volumes are consistent with a practice that performs frequent extractions and related visits rather than a low-volume specialty referral center.

Average paid-per-claim values for the top codes indicate how revenue is generated across procedure types: D7240 pays $175 avg/claim, D7210 pays $80 avg/claim, and D9223 pays $93 avg/claim. Combined with the high claim counts, the relatively modest per-claim payments for extraction codes suggest the practice depends on scale to produce $3.8M in Medicaid revenue.

The provider’s long NPI tenure—enumerated 2006-08-31 (~20 years ago)—indicates a sustained, established presence in the market. That length of activity, together with consistently high ranks on several in-state codes, supports the interpretation of an entrenched operator with an established referral or patient flow for surgical dental care.

Concentration risk is material because a small number of codes account for most revenue: top three codes make up 64.0% of Medicaid revenue and D7210 alone is 22.5% of the total. Any payer policy, fee schedule change, or utilization shift affecting these few high-volume codes could meaningfully affect the practice’s revenue given its Medicaid-dependent, code-concentrated profile.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D7240	N/A	6,190	$180	$1.1M
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	10,760	$80	$860.4K
D9223	N/A	5,430	$90	$504.9K
D7230	N/A	2,600	$150	$390K
D9222	N/A	4,020	$100	$381.5K
D0160	N/A	8,160	$40	$293.6K
D1999	N/A	7,480	$20	$112.3K
D7220	N/A	660	$120	$80.9K
D0330	N/A	2,530	$30	$78.4K
D7250	N/A	510	$60	$27.8K

Showing 1–10 of 13

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

Jose Diaz-abascal — 3 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	4	30	980	$170	$378.3K
D7230	N/A	2	20	270	$150	$117.6K
D9223	N/A	2	40	120	$110	$98.2K
D9222	N/A	3	30	300	$110	$97.4K
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	2	100	150	$80	$83K
D0160	N/A	2	60	330	$40	$60.4K
D7220	N/A	4	10	180	$120	$56.8K
D1999	N/A	57	950	1,350	$10	$35.1K
D0330	N/A	52	540	370	$30	$25.3K
D7250	N/A	6	30	160	$60	$14.2K

Showing 1–10 of 13

Nearby Providers

Other providers in the same ZIP code as Jose Diaz-abascal, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Vazquez-morales	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$3.1M
Inspira Behavioral Care Corp.	PR	Adult Mental Health Clinic/Center	$0	$1.7M
Benigno Lopez	PR	Orthopaedic Surgery Physician	$0	$1.3M
St Lukes Episcopal Church Home Care Program	PR	Home Health Agency	$0	$1.1M
Rafael Figueroa	PR	Specialist	$0	$731.1K
Hector Ramos-fuentes	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$656.4K
Elissa Carrera Gonzalez	PR	Internal Medicine Physician	$24K	$0
Luis Ferrer Torres	PR	Anatomic Pathology & Clinical Pathology Physician	$9.1K	$0
Armando Sanchez Burgos	PR	General Practice Physician	$5.1K	$0

Jose Diaz-abascal — Billing Profile & Reimbursement Data

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Jose Diaz-abascal — 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