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.

Metro Mayaguez Inc (NPI 1821082918)

Key Findings

Field	Value
Entity Type	Organization
Organization	Metro Mayaguez Inc
Address	#15 Dr Basora Street
City	Mayaguez
State	PR
ZIP	00680
Taxonomy	General Acute Care Hospital
NPI Enumerated	September 6, 2005

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

METRO MAYAGUEZ INC is effectively a single‑payer Medicaid provider: there is no Medicare billing on file while reported Medicaid revenue totals $4.9M. This concentration means the provider’s financial footprint in public payers is driven entirely by Medicaid flows and payers/analysts should treat Medicare exposure as absent in any commercial/Medicare competitive comparisons.

Revenue is highly concentrated in a small set of imaging codes: the top three Medicaid codes (74176, 70450, 76641) together account for 56.7% of the provider’s total Medicaid revenue. In particular, 74176 alone generates $1.9M (39.9% of Medicaid revenue), making a single CT abdominal/pelvic service the largest single revenue driver.

The provider’s service mix indicates an imaging-focused acute-care operation. High-revenue, high-volume diagnostic imaging codes dominate the list (CT abdomen/pelvis 74176, CT head 70450, breast ultrasound 76641, CT thorax 71250), plus notable volumes in mammography (77067) and chest X‑rays (71045), suggesting the facility operates substantial radiology/diagnostic capacity rather than an inpatient procedural or specialty-dominant caseload.

METRO MAYAGUEZ holds dominant statewide positions on several CT measures: 74176 (CT abdomen/pelvis) ranks #1 of 77 providers in-state and is described as an extreme outlier, and 71250 (CT thorax without contrast) ranks #1 of 37 providers and is also an extreme outlier. These rankings and labels indicate the provider is a major, above‑typical volume center for CT imaging within Puerto Rico.

Several other imaging codes show consistently elevated state percentile ranks, reinforcing the impression of a high-throughput diagnostic imaging hub. Examples include 70450 (CT head) at the 87th percentile, 76641 (breast ultrasound) at the 89th percentile, 76830 (transvaginal ultrasound) at the 96th percentile, and 76700 (abdominal ultrasound) at the 95th percentile; the plain‑English descriptors attached to many of these codes are “typical, unremarkable volume” or “notably above typical,” conveying persistently above‑average utilization across modalities.

Although imaging dominates revenue, revenue per claim varies widely across codes: large claim counts with low per‑claim payments (e.g., 71045 chest X‑ray: 17.6K claims at $7 avg paid/claim, $123.1K revenue) sit alongside fewer, higher‑paid diagnostic services (e.g., 93306 echo: 1.6K claims at $155 avg paid/claim, $249.7K). This mix implies operational scale in high‑throughput, lower‑unit‑reimbursement studies supplemented by selective higher‑unit services.

Dependence on a handful of imaging codes creates concentration risk and strategic implications for payers and competitors. With 74176 generating $1.9M (39.9%) and the top three codes making up 56.7% of Medicaid revenue, reimbursement changes, modality shifts, or network negotiations focused on CT and breast imaging could materially affect the provider’s Medicaid revenue.

The NPI has been enumerated since 2005-09-06 (~21 years ago), indicating long tenure in the market. Combined with the high state rankings on core imaging codes, this tenure suggests an established local presence and potentially entrenched diagnostic referral patterns within the region.

Medicaid: Complete Services Breakdown

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

61 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	11,160	$170	$1.9M
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.	5,910	$90	$531.5K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	5,040	$50	$266.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1,610	$160	$249.7K
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.	1,300	$170	$222K
71250	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material.	2,220	$90	$193.1K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	5,750	$30	$189.9K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	4,120	$40	$160.7K
76700	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	3,540	$40	$134.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	17,590	$10	$123.1K

Showing 1–10 of 61

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

Metro Mayaguez Inc — 7 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

61 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	1	80	900	$110	$242K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	43	210	380	$210	$230.1K
50590	Extracorporeal shock wave lithotripsy (ESWL) is a procedure used to destroy calculus (kidney stones) in the kidneys and ureters.	13	20	120	$580	$193.3K
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.	25	70	730	$110	$178.7K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	19	150	1,180	$70	$170.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	94	110	270	$280	$148.1K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	21	180	890	$70	$145.5K
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.	11	80	1,150	$50	$125.5K
77066	The provider performs X–ray imaging on both breasts in a patient with a lump or suspected cancer and may use specially designed computer software to help identify or diagnose potential abnormalities…	26	130	480	$90	$109.4K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	38	50	160	$220	$84.5K

Showing 1–10 of 61

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carlos Rosario Sepulveda	PR	Cardiovascular Disease Physician	$2.8K	$357K
Jeffrey Zuckerman	PR	Diagnostic Radiology Physician	$131.1K	$2.1K
Fernando Lopez Rodriguez	PR	Neuroradiology Physician	$41.6K	$37.6K
Josue Vazquez Delgado	PR	Diagnostic Radiology Physician	$26.4K	$0
Angela Mendez De Guzman	PR	Diagnostic Radiology Physician	$10.6K	$0
Ana Suarez Lozada	PR	Diagnostic Radiology Physician	$8K	$0
Elena Alvarez Westwood	PR	Diagnostic Radiology Physician	$6.4K	$0
Carlos Gonzalez Garcia	PR	Diagnostic Radiology Physician	$3.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Centro Neumologico Del Oeste	PR	Pulmonary Disease Physician	$0	$2.2M
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

Metro Mayaguez Inc — 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