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.

Juan Raya (NPI 1699212175)

Field	Value
Entity Type	Individual
Organization	Juan Raya
Address	Carretera 728, Calle Jose C. Vazquez,
City	Aibonito
State	PR
ZIP	00705
Taxonomy	General Practice Physician
NPI Enumerated	January 23, 2017

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99234	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	10,110	$50	$535.7K
99235	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	2,750	$120	$335.1K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	580	$160	$91.2K
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…	750	$110	$83.9K
99220	N/A	320	$130	$39.8K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	650	$30	$20.1K
99218	N/A	170	$60	$10K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	950	$10	$7.6K
99219	N/A	80	$100	$7.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	480	$10	$6.7K

Showing 1–10 of 14

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

Juan Raya — 2 of 14 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

14 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99235	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	4	160	310	$120	$81.8K
99234	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	1	220	320	$80	$66.7K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	76	180	170	$80	$55.3K
99220	N/A	27	80	160	$120	$48K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	101	500	130	$90	$43.1K
99219	N/A	63	90	150	$70	$36.4K
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…	47	320	100	$80	$31.3K
99218	N/A	59	120	180	$50	$26.2K
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…	222	250	180	$30	$23.1K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	26	110	180	$40	$15.7K

Showing 1–10 of 14

Nearby Providers

Other providers in the same ZIP code as Juan Raya, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mennonite General Hospital Inc	PR	Specialist	$0	$8.3M
Sandra Gracia-lopez	PR	Nuclear Medicine Physician	$26.7K	$4.1M
Arecibo Pathology Services Csp	PR	Anatomic Pathology & Clinical Pathology Physician	$0	$3.8M
Mennonite General Hospital Inc	PR	General Acute Care Hospital	$0	$2.8M
Clinica Oftalmica De La Montana, C.s.p.	PR	Exclusive Provider Organization	$0	$2M
Marie Lugo	PR	Sports Medicine (Physical Medicine & Rehabilitation) Physician	$1.1K	$1.7M
Vital-care Medical Center L.L.C.	PR	Multi-Specialty Clinic/Center	$0	$1.3M
Carlene Cadiz Fuentes	PR	Obstetrics & Gynecology Physician	$0	$1.2M
Clinica De Manejo Del Dolor Dr Crawford W Long C S P	PR	Pain Medicine (Anesthesiology) Physician	$0	$1M
Nestor Sanchez Colon	PR	Dermatopathology Physician	$34.6K	$992.5K

Juan Raya — Billing Profile & Reimbursement Data

Sign up for Juan Raya — Billing Profile & Reimbursement Data policy alerts

Juan Raya — Billing Profile & Reimbursement Data

Sign up for Juan Raya — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References