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.

Access Medical Group Corp (NPI 1811204563)

Access Medical Group Corp is a clinic/center provider located in Bayamon, Puerto Rico. This profile covers 0 Medicare and 92 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	Access Medical Group Corp
Address	E7 Calle Santa Cruz
City	Bayamon
State	PR
ZIP	00961
Taxonomy	Clinic/Center
NPI Enumerated	September 1, 2010

Payer Source	Total Paid
Medicaid	$803.8K
Medicare	$0

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

92 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	164,060	$1	$328.1K
96160	The 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…	12,100	$20	$229.8K
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…	3,260	$20	$55.3K
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	4,000	$10	$48K
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…	650	$40	$28.1K
99442	N/A	7,740	$1	$23.2K
97802	The 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…	1,700	$10	$20.4K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	810	$20	$16.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	13,990	$1	$14K
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…	740	$20	$11.8K

Showing 1–10 of 92

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

Access Medical Group Corp — 3 of 16 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

92 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	40	90	1,090	$10	$47K
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…	337	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…	11	3,230	330	$10	$42.4K
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…	49	1,400	160	$50	$29.6K
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…	59	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…	197	410	390	$20	$21.7K
97802	The 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…	16	130	210	$30	$20.9K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	234	320	470	$10	$20K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	48	840	340	$1	$16.7K
96160	The 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…	11	470	70	$10	$15.2K

Showing 1–10 of 92

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nazareno Enterprises And Services LLC	PR	Prosthetic/Orthotic Supplier	$0	$23.8M
Cdt Gmsp, Inc	PR	Federally Qualified Health Center (FQHC)	$0	$4.6M
Centro Medico Del Turabo, Inc.	PR	Home Infusion Therapy Pharmacy	$0	$3.9M
Djm Imaging Center LLC	PR	Radiology Clinic/Center	$0	$3.6M
Cdt Centro De Servicios Medicos Integrados Inc.	PR	Clinical Medical Laboratory	$0	$2.3M
Cdt G.m,s.p., Inc Radiologia	PR	Federally Qualified Health Center (FQHC)	$0	$1.7M
Pro-health Clinical Services LLC	PR	Endocrinology, Diabetes & Metabolism Physician	$0	$1.6M
Edilberto Martinez	PR	Maternal & Fetal Medicine Physician	$0	$1.4M
Laboratorio Teresita	PR	Clinical Medical Laboratory	$4.8K	$1.3M
Dr Joaquin Balaguer Group Psc	PR	Podiatrist	$0	$1.2M

Access Medical Group Corp — Billing Profile & Reimbursement Data

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Access Medical Group Corp — 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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