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.

Women's Health Institute, Psc (NPI 1699216069)

Women's Health Institute, Psc is a gynecology physician provider located in Caguas, Puerto Rico. This profile covers 0 Medicare and 12 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	Women's Health Institute, Psc
Address	100 Ave Luis Munoz Marin
City	Caguas
State	PR
ZIP	00725
Taxonomy	Gynecology Physician
NPI Enumerated	March 17, 2017

Payer Source	Total Paid
Medicaid	$2.9M
Medicare	$0

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
58558	The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples…	1,430	$1,100	$1.6M
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…	11,720	$50	$574K
57454	In this procedure, the provider examines the cervix, including the upper/adjacent portion of the vagina, using an instrument called a colposcope, and also performs biopsy(s) of the cervix and…	1,840	$200	$364.1K
58340	In this procedure, the provider introduces a catheter with saline or contrast material into the woman's uterus or the fallopian tubes at the same time as ultrasound or X–ray imaging. This procedure…	1,080	$150	$159.3K
76831	The provider performs an ultrasound examination during which he infuses saline into the uterus and may also use color flow Dopper to enhance imaging.	1,080	$80	$82.4K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	2,310	$30	$66.9K
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.	190	$90	$17K
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…	370	$40	$14.2K
99203	The provider sees a new 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 provider…	180	$50	$9.8K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	410	$20	$7.4K

Showing 1–10 of 12

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

Women's Health Institute, Psc — 2 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
58340	In this procedure, the provider introduces a catheter with saline or contrast material into the woman's uterus or the fallopian tubes at the same time as ultrasound or X–ray imaging. This procedure…	1	10	1,080	$150	$159.2K
58558	The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples…	1	20	50	$590	$105.5K
76831	The provider performs an ultrasound examination during which he infuses saline into the uterus and may also use color flow Dopper to enhance imaging.	1	10	1,080	$80	$82.5K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	113	230	410	$40	$51.9K
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.	122	220	290	$60	$47.2K
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…	112	280	210	$30	$43.8K
57454	In this procedure, the provider examines the cervix, including the upper/adjacent portion of the vagina, using an instrument called a colposcope, and also performs biopsy(s) of the cervix and…	1	10	60	$140	$42.8K
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…	172	3,230	330	$10	$42.4K
99203	The provider sees a new 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 provider…	647	1,400	160	$50	$29.6K
57150	In this procedure, the provider washes out the vaginal canal and may also instill medication when the patient has a bacterial, fungal, or parasitic disease.	3	10	210	$40	$18.6K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Borinquen, Inc	PR	Clinical Medical Laboratory	$1.4M	$37.1M
Msl Therapeutical Services, Psc	PR	Occupational Therapist	$0	$12.8M
Laboratorio Clinico Bairoa Inc	PR	Clinical Medical Laboratory	$271.3K	$11.3M
Centro Medico Del Turabo Inc	PR	Multi-Specialty Clinic/Center	$0	$10.8M
Mediko Imaging Inc.	PR	Radiology Clinic/Center	$0	$6.8M
Consolidated Radiology Complex Csp	PR	Radiology Clinic/Center	$0	$6.8M
Caribbean Heart Institute LLC	PR	Clinical Cardiac Electrophysiology Physician	$0	$5.7M
Nuscan Csp	PR	Nuclear Medicine Physician	$0	$5.5M
Conmed Laboratories Inc	PR	Clinical Medical Laboratory	$105.5K	$5.4M
Sps Specialty Pharmacy Services Inc	PR	Specialty Pharmacy	$0	$4.2M

Women's Health Institute, Psc — Billing Profile & Reimbursement Data

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Women's Health Institute, Psc — 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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