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.

Centro Neumologico Del Oeste (NPI 1760463970)

Centro Neumologico Del Oeste is a pulmonary disease physician provider located in Mayaguez, Puerto Rico. This profile covers 0 Medicare and 18 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	Centro Neumologico Del Oeste
Address	55 Calle De Diego E
City	Mayaguez
State	PR
ZIP	00680
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	November 7, 2005

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	14,290	$60	$871.9K
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…	17,420	$50	$836.2K
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…	4,440	$60	$261.7K
94726	The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may…	1,660	$50	$89.7K
94729	In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.	1,730	$40	$76.3K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	250	$130	$32.6K
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…	160	$100	$15.2K
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…	80	$160	$12.6K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	620	$20	$9.3K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	180	$50	$8.6K

Showing 1–10 of 18

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

Centro Neumologico Del Oeste — 5 of 18 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

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	361	390	290	$80	$96.8K
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	1	30	350	$50	$75.1K
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…	302	500	130	$90	$43.1K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	800	900	360	$30	$42.5K
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…	133	3,230	330	$10	$42.4K
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…	139	320	100	$80	$31.3K
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…	28	1,400	160	$50	$29.6K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	52	70	240	$30	$24.4K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	162	530	100	$70	$22.9K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	172	410	390	$20	$21.7K

Showing 1–10 of 18

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Metro Mayaguez Inc	PR	General Acute Care Hospital	$0	$4.9M
Migrant Health Center Western Region,inc	PR	Clinical Medical Laboratory	$5.2K	$4.8M
Alameda Prosthodontic Services, Psc	PR	Prosthodontics	$0	$3.9M
Oscar Muniz	PR	Oral and Maxillofacial Pathology Dentistry	$0	$3.5M
Juan Garcia	PR	Oral and Maxillofacial Surgery (Dentist)	$0	$2.9M
Migrant Health Center Western Region,inc	PR	Federally Qualified Health Center (FQHC)	$0	$2.4M
Lynette Baez Torres	PR	Ophthalmology Physician	$0	$1.9M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$0	$1.6M
Jesus Romero Perez	PR	Diagnostic Radiology Physician	$8.1K	$1.4M
Laboratorio Clinico Irizarry Guasch Inc	PR	Clinical Medical Laboratory	$164.2K	$1.2M

Centro Neumologico Del Oeste — Billing Profile & Reimbursement Data

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Centro Neumologico Del Oeste — 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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