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.

Municipality Of San Juan (NPI 1750667572)

Key Findings

Field	Value
Entity Type	Organization
Organization	Municipality Of San Juan
Address	Bo. Monacillos Centro Medico
City	San Juan
State	PR
ZIP	00936
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	October 25, 2011

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

MUNICIPALITY OF SAN JUAN is effectively a single‑payer provider in the available data: there is no Medicare billing on file while total Medicaid revenue is $4.5M. The provider’s NPI has been enumerated since 2011-10-25 (~15 years ago), indicating an established presence in the market but with current dependence on Medicaid flows.

Revenue is highly concentrated in a small number of evaluation-and-management (E/M) codes: the top three Medicaid codes (99215, 99232, 99213) account for 62.2% of this provider’s total Medicaid revenue. In dollar terms those codes are 99215 $1.5M (34.6%), 99232 $814.2K (18.5%), and 99213 $405.3K (9.2%), which signals a reliance on high‑acuity outpatient and inpatient E/M services for most revenue.

The code mix indicates a combined outpatient and inpatient E/M footprint with significant high‑complexity outpatient care: 99215 (30.5K claims, $50 avg paid/claim) is the single largest revenue driver, and substantial volumes of 99232 (24.7K claims, $33 avg) show ongoing inpatient/observation care. The presence of high‑level consultation code 99245 (7.8K claims, $44 avg) and initial inpatient codes such as 99221 further confirm a multi‑setting clinical operation consistent with a multispecialty clinic/center.

This provider operates at very high volume but with low average payment per encounter: for example 99215 has 30.5K claims at an average paid $50/claim and 99232 has 24.7K claims at $33/claim. Those unit values combined with the claim counts imply a high‑throughput, low‑unit‑rate service model where scale is the primary revenue driver rather than high per‑claim payments.

On statewide competitive standing, MUNICIPALITY OF SAN JUAN is a dominant outlier for several Medicaid codes: 99215 ranks #2 of 282 providers in-state (100th percentile; extreme outlier) and 99232 ranks #4 of 456 (99th percentile; extreme outlier). These percentiles indicate the provider is a major player in Puerto Rico for high‑complexity E/M services, far above typical state volumes for those codes.

Beyond E/M, the provider bills meaningful volumes of on‑site diagnostics and imaging—notably 76805 (4.7K claims, $28 avg, $130.3K revenue) which ranks #2 of 117 in-state (99th percentile). Additional procedure and imaging codes (CT 74177, 74176, CT head 70450, EKG 93010) and therapy codes (97110, 97035, 97032) show a broad service mix consistent with an onsite diagnostic and ancillary services capability that supports multispecialty care.

The provider’s high concentration in a few E/M codes poses revenue concentration risk: with 62.2% of Medicaid revenue coming from the top three codes, shifts in utilization, coding practices, or Medicaid policy affecting those specific E/M services would disproportionately affect overall revenue. Diversification across diagnostics and therapy codes is present but represents a much smaller share of total Medicaid income.

Operationally, the combination of large claim volumes (e.g., 30.5K claims for 99215 and 24.7K for 99232), modest average paid/claim amounts, and strong in‑state ranks suggests established throughput capacity and likely integration with inpatient/observation workflows. For analysts, these patterns point to a provider whose financial performance and competitive influence in Puerto Rico are driven by high‑volume E/M services rather than procedure‑heavy or high‑unit‑price specialties.

Medicaid: Complete Services Breakdown

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

55 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	30,480	$50	$1.5M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	24,670	$30	$814.2K
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…	6,760	$60	$405.3K
99245	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends…	7,780	$40	$342.4K
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…	2,830	$80	$215K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	4,540	$40	$199.9K
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…	4,550	$30	$150.1K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	4,660	$30	$130.3K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	1,840	$50	$93.6K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	8,170	$10	$73.5K

Showing 1–10 of 55

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

Municipality Of San Juan — 8 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

55 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	132	140	2,620	$50	$505.7K
99292	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3	10	80	$330	$446.1K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	47	80	900	$110	$242K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	23	70	730	$110	$178.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	29	80	1,150	$50	$125.5K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	23	40	130	$210	$122.8K
99233	The provider sees a patient for a subsequent 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	390	290	$80	$96.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	121	180	2,150	$20	$95.2K
97032	Electrical stimulation therapy uses electricity to stimulate the muscles for the treatment of pain and other disorders associated with muscles. Electrodes are placed on the affected muscle areas and…	129	160	3,960	$20	$89.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	5	20	80	$70	$75.4K

Showing 1–10 of 55

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Omayra Gonzalez	PR	Hematology & Oncology Physician	$2.9K	$1.6M
Laboratorio Clinico Dr. Gualberto Rabell	PR	Clinical Medical Laboratory	$0	$1.5M
Edilberto Martinez	PR	Maternal & Fetal Medicine Physician	$0	$1.4M
Lauren Lynch	PR	Maternal & Fetal Medicine Physician	$0	$1.4M
Luis Font	PR	Pediatric Endocrinology Physician	$0	$836.4K
Soobin Maeng	PR	General Practice Physician	$0	$738.9K
Laboratorio Clinico Cdt Dr. Jose Lopez Antongiorgi	PR	Clinical Medical Laboratory	$0	$607.1K
Ricardo Hernandez-castillo	PR	Pulmonary Disease Physician	$28.6K	$211.9K
Eva Gonzalez Mendez	PR	Endocrinology, Diabetes & Metabolism Physician	$30.6K	$56K
Eugenia Galindo-ramos	PR	Nephrology Physician	$66.3K	$7.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ffv Id Med Group Psc	PR	Infectious Disease Physician	$0	$3M
Michelle Gomez Cruz	PR	Pediatric Endocrinology Physician	$0	$1.2M
Cardiovascular Anesthesia De Puerto Rico, Psc	PR	Anesthesiology Physician	$0	$1.1M
Recinto De Ciencias Medicas	PR	Dermatology Physician	$0	$1.1M
Recinto De Ciencias Medicas	PR	Otolaryngology/Facial Plastic Surgery Physician	$0	$881.7K
Recinto De Ciencias Medicas	PR	Cardiovascular Disease Physician	$0	$842.2K
Recinto De Ciencias Medicas	PR	Endocrinology, Diabetes & Metabolism Physician	$0	$693.7K
Juan Aviles	PR	Internal Medicine Physician	$15K	$276.9K
Jose Kareh Cordero	PR	Cardiovascular Disease Physician	$7.3K	$57.1K
Ernesto Sola Sanchez	PR	Endocrinology, Diabetes & Metabolism Physician	$13.6K	$49.5K

Municipality Of San Juan — 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