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.

Puerto Rico Pathology Associates P (NPI 1740246545)

Key Findings

Field	Value
Entity Type	Organization
Organization	Puerto Rico Pathology Associates P
Address	198 Calle Trinidad Ste 102
City	San Juan
State	PR
ZIP	00917
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	April 21, 2006

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

PUERTO RICO PATHOLOGY ASSOCIATES P reports no Medicare billing on file and $6.8M in lifetime Medicaid revenue, making its active payer footprint effectively single‑payer Medicaid at this scale. The absence of Medicare activity should be interpreted as a lack of reported Medicare reimbursement rather than a statement about clinical capability; Medicaid represents the entirety of observed claims revenue for this NPI.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 74.8% of this provider’s Medicaid revenue, driven by 88305 ($3.4M, 50.6%), 88342 ($1.3M, 19.2%), and 88173 ($336.8K, 5.0%). This concentration indicates that a small set of pathology and cytopathology services are the primary revenue drivers for the practice.

The provider’s code mix and volumes indicate a lab-oriented anatomic and clinical pathology operation focused on surgical pathology and immunohistochemistry plus cytology from needle aspirates. High claim volumes for 88305 (34.7K claims, $99 avg paid/claim) and 88342 (13.2K claims, $99 avg paid/claim) alongside cytology codes such as 88173 (3K claims, $111 avg paid/claim) show routine processing of surgical specimens, IHC stains, and FNA interpretation as core services.

Competitive standing within Puerto Rico: for 88305 this provider ranks #4 of 32 providers and is in the 90th percentile, for 88342 it ranks #3 of 15 (86th percentile), and for 88173 it ranks #3 of 12 (82th percentile). These rankings place the provider among the higher‑volume state performers for its top codes, but the profile notes these are "typical, unremarkable" volumes—so the practice is an active, above‑median participant rather than a statewide monopoly.

There are targeted outlier signals on a few narrower codes: 88177 is ranked #1 of 3 providers (100th percentile) with 1.9K claims and $60.3K revenue, making the practice a top reporter for additional immediate adequacy evaluations after FNAs in‑state. The provider also shows notable COVID testing activity (87635: 3.2K claims, $48 avg paid/claim, $155.5K revenue) and specimen collection (G2023: 3.2K claims, $25 avg paid/claim, $79.3K revenue), indicating capacity for high‑throughput molecular and specimen logistics.

Beyond the dominant pathology codes, the practice bills a range of molecular and infectious disease tests and specimen procedures—examples include HPV testing 87624 (3K claims, $38 avg paid/claim, $114.3K revenue), Chlamydia 87491 (2.1K claims, $29 avg paid/claim, $60.6K revenue), Gonorrhea 87591 (2.1K claims, $29 avg paid/claim, $60.5K revenue), and fine needle aspiration 10005 (1.7K claims, $82 avg paid/claim, $138.7K revenue). This breadth in codes suggests operational diversification across cytology, molecular diagnostics, and sexually transmitted infection testing in addition to core surgical pathology.

The practice has an established tenure on file (NPI enumerated 2006-04-21, ~20 years ago), which aligns with the sustained claim volumes reported for core pathology CPTs such as 88305 and 88342. Longevity combined with the concentrated Medicaid revenue footprint suggests a mature lab practice with long‑standing Medicaid relationships and service lines oriented to histopathology and cytopathology.

Medicaid: Complete Services Breakdown

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	34,670	$100	$3.4M
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	13,170	$100	$1.3M
88173	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate and then interprets and reports the results.	3,030	$110	$336.8K
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	1,420	$140	$192.6K
88313	The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,…	2,110	$80	$169K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	1,260	$130	$166.7K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	3,240	$50	$155.5K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4,240	$30	$144.3K
10005	Under ultrasound guidance, the provider performs a fine needle aspiration (FNA), a diagnostic procedure that involves collecting a specimen from tissue, a cyst, or mass using a specialized needle and…	1,690	$80	$138.7K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	3,010	$40	$114.3K

Showing 1–10 of 31

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

Puerto Rico Pathology Associates P — 1 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

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4	30	4,250	$80	$1.3M
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	6	10	1,420	$300	$1.2M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	11	10	4,190	$30	$655.7K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	11	30	910	$40	$638.8K
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	9	20	1,210	$190	$535.5K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	20	30	1,210	$150	$530.3K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	3	20	2,030	$80	$485.9K
88142	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	9	50	370	$20	$247.3K
88173	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate and then interprets and reports the results.	3	10	1,220	$120	$238.7K
10005	Under ultrasound guidance, the provider performs a fine needle aspiration (FNA), a diagnostic procedure that involves collecting a specimen from tissue, a cyst, or mass using a specialized needle and…	4	10	1,530	$90	$215K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Metro Pavia At Home LLC	PR	Home Health Agency	$0	$5.6M
Centro De Rehabilitacion Y Electrodiagnostico De Hato Rey, LLC	PR	Physical Medicine & Rehabilitation Physician	$0	$1.8M
Retina Consultants Of P.r.	PR	Ophthalmology Physician	$0	$1.7M
Er Specialized Care LLC	PR	Emergency Medical Services (Emergency Medicine) Physician	$0	$1.5M
Aid System LLC	PR	Diagnostic Radiology Physician	$0	$1.3M
Rvp Dental Medical Center, LLC	PR	Dental Clinic/Center	$0	$948.1K
Oncology & Body Imaging Psc	PR	Diagnostic Radiology Physician	$0	$905.6K
Endourological Institute Inc	PR	Ambulatory Surgical Clinic/Center	$16.9K	$609.4K
Mirelis Acosta	PR	Hematology & Oncology Physician	$6.3K	$215.1K
Gabriela Trabal-yulfo	PR	Ophthalmology Physician	$24.3K	$185.1K

Puerto Rico Pathology Associates P — Billing Profile & Reimbursement Data

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Puerto Rico Pathology Associates P — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gabriel Acosta Gonzalez	PR	Anatomic Pathology & Clinical Pathology Physician	$49.1K	$0
Sara Sanz Lebron	PR	Anatomic Pathology & Clinical Pathology Physician	$37.7K	$0
Manuel Rivero Iturregui	PR	Anatomic Pathology & Clinical Pathology Physician	$24.3K	$0
Annelisse Santiago Pintado	PR	Anatomic Pathology & Clinical Pathology Physician	$22.3K	$0
Victor Carlo-chevere	PR	Anatomic Pathology & Clinical Pathology Physician	$13.5K	$0
Wilma Virella-santana	PR	Anatomic Pathology & Clinical Pathology Physician	$3.8K	$0
Luis Ramos	PR	Anatomic Pathology & Clinical Pathology Physician	$3.2K	$0