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.

Laboratorio Clinico Borges (NPI 1770858797)

Laboratorio Clinico Borges is a clinical medical laboratory provider located in San Juan, Puerto Rico. This profile covers 0 Medicare and 42 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	Laboratorio Clinico Borges
Address	168 Calle Arzuaga
City	San Juan
State	PR
ZIP	00925
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	March 9, 2012

Payer Source	Total Paid
Medicaid	$679.7K
Medicare	$0

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

42 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	2,130	$40	$89.4K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	5,730	$10	$80.2K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	6,030	$10	$72.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	8,730	$10	$61.1K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	2,480	$20	$59.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	6,560	$10	$59K
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…	890	$50	$45.2K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	1,650	$30	$41.3K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	3,690	$10	$29.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	8,400	$1	$25.2K

Showing 1–10 of 42

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

Laboratorio Clinico Borges — 0 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

42 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	216	650	1,260	$40	$93.7K
87490	The lab analyst performs a test for Chlamydia trachomatis using direct nucleic acid probe technique. Chlamydia trachomatis causes a common sexually transmitted disease and certain eye infections.	45	70	150	$20	$71.9K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	172	770	2,520	$20	$65.5K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	197	590	1,440	$20	$65.4K
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…	91	370	370	$50	$63.3K
87590	The lab analyst performs a test for Neisseria gonorrhoeae, a bacteria, using direct nucleic acid probe technique.	62	80	150	$20	$59.4K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	161	810	2,350	$10	$52.7K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	140	790	2,360	$10	$41.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	155	850	3,250	$10	$40.5K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	163	650	630	$30	$35.8K

Showing 1–10 of 42

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Special Care Pharmacy Services, LLC	PR	Pharmacy	$0	$12.9M
Laboratorio Clinico Rio Piedras I	PR	Clinical Medical Laboratory	$0	$702.3K
Carmen Amaral	PR	Ophthalmology Physician	$990	$673.3K
Walgreen Co	PR	Pharmacy	$78.2K	$0
Maria Zweig	PR	Specialist	$26.8K	$0
Brenda Orta Rodriguez	PR	Geriatric Physical Therapist	$21.6K	$0
Gloriva Pina	PR	Counseling Psychologist	$0	$19.6K
Ivelisse Sambolin Jessurun	PR	Physical Medicine & Rehabilitation Physician	$19.4K	$0
Ricardo Gago Pinero	PR	Rheumatology Physician	$13.6K	$0
Roberto Buxeda	PR	Ophthalmology Physician	$5.6K	$5.5K

Laboratorio Clinico Borges — Billing Profile & Reimbursement Data

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Laboratorio Clinico Borges — 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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