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    OpenPayerNPI Medicare & MedicaidSouthern Hospital Service Inc
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    Southern Hospital Service Inc — Billing Profile & Reimbursement Data

    NPI 1790804680 · Villalba, PR · Multi-Specialty Clinic/Center

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    Southern Hospital Service Inc is a multi-specialty clinic/center provider located in Villalba, Puerto Rico. This profile covers 0 Medicare and 72 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationSouthern Hospital Service Inc
    Address40 Calle Munoz Rivera
    CityVillalba
    StatePR
    ZIP00766
    TaxonomyMulti-Specialty Clinic/Center
    NPI EnumeratedMarch 29, 2007

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$753.1K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    72 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The 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…79,800$10$558.6K
    G2012Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an…11,280$10$67.7K
    90472This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.3,990$10$43.9K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.5,560$10$33.4K
    90670This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…1,390$10$6.9K
    99392Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…2,900$1$5.8K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.2,410$1$4.8K
    90649This code represents a quadrivalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against four HPV types (6, 11, 16,…1,170$1$3.5K
    0003AN/A90$40$3.4K
    0072AN/A80$40$3.2K

    Showing 1–10 of 72

    • More pages

    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.

    Full comparison — all codes billed, vs. Puerto Rico median

    72 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99284The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.184340210$70$81.7K
    99213The 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…323,230330$10$42.4K
    90472This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.351701,560$10$28K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.422101,600$10$27.7K
    0002AN/A119160310$30$23.3K
    97802The provider treats medical conditions and related symptoms using specific diet therapy by interacting individually with the patient. This code represents each 15 minutes of the first visit with the…109130210$30$20.9K
    0001AN/A127160370$30$20.7K
    96160The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient, analyzes the results, assigns a score, and documents the findings. Use this code for each…4047070$10$15.2K
    0012AN/A106140240$30$11.9K
    0003AN/A69120120$40$11.2K

    Showing 1–10 of 72

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    Nearby Providers

    Other providers in the same ZIP code as Southern Hospital Service Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Laboratorio Sagrada Familia Corp.PRClinical Medical Laboratory$4.6K$3M
    Southern Hospital ServicesPREmergency Medical Services (Emergency Medicine) Physician$0$1.6M
    Cdva CorpPRHealth Maintenance Organization$1.5K$1.5M
    Laboratorio Clinico Tierra Santa IncPRClinical Medical Laboratory$2K$1M
    Southern Hospital ServicesPRClinical Medical Laboratory$0$976.5K
    Laboratorio Clinico Alfeciza Inc.PRClinical Medical Laboratory$0$446K
    Empresas Bonilla Colon IncPRCommunity/Retail Pharmacy$83.3K$190.3K

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Puerto Rico Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Puerto Rico Distribution
    Southern Hospital Service Inc — 3 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Puerto Rico