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.

Arecibo Pathology Services Csp (NPI 1831132844)

Key Findings

Field	Value
Entity Type	Organization
Organization	Arecibo Pathology Services Csp
Address	Calle Jose C. Vazquez Esquina Troyer
City	Aibonito
State	PR
ZIP	00705
Taxonomy	Anatomic Pathology & Clinical Pathology Physician
NPI Enumerated	June 14, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

ARECIBO PATHOLOGY SERVICES CSP is a long-tenured anatomic/clinical pathology practice in AIBONITO, PR, with its NPI enumerated on 2006-06-14 (~20 years ago). The provider’s billing footprint is effectively single-payer: there is no Medicare billing on file and all recorded federal program revenue is Medicaid-only totaling $3.8M. This tenure combined with a single-payer Medicaid exposure shapes both referral patterns and revenue risk concentration.

Revenue concentration is highly focused: the precomputed top three Medicaid codes (88305, 88307, 88312) account for 80.4% of the provider’s total Medicaid revenue. Individually those codes are 88305 ($1.3M, 35.4%), 88307 ($1.1M, 29.2%), and 88312 ($599.3K, 15.7%), which together dominate the practice’s Medicaid receipts and indicate dependence on a narrow set of surgical-pathology and special-stain services.

The code mix and volumes indicate this is an operation centered on surgical pathology interpretation with significant technical staining work: 88305 (18K claims, $75 avg paid/claim), 88307 (5.6K claims, $198 avg paid/claim), and 88312 (4.9K claims, $123 avg paid/claim) show heavy throughput of level IV–V pathology examinations plus Group I special stains. Those claim counts and average paid-per-claim levels are consistent with a lab that performs both the pathologist’s diagnostic reads and the technical staining/slide preparation workflows.

State-level competitive standing for the top codes is solid but not dominant. For example, 88305 ranks #7 of 32 providers in-state (81th percentile) and is described as "typical, unremarkable volume for this code," while 88307 ranks #4 of 18 (82th percentile) and 88312 ranks #5 of 25 (83th percentile); these positions indicate the provider is a mid‑to‑upper-tier Medicaid pathology participant in Puerto Rico but not a statewide leader.

Beyond the top three, the practice also bills across multiple surgical pathology levels, which suggests a full-range surgical pathology service line rather than a narrowly scoped niche. Notable examples include 88304 (7.9K claims, $245.6K, 6.5% of Medicaid revenue; ranks #4 of 22, 86th percentile) and 88302 (3.8K claims, $149.1K, 3.9% of Medicaid revenue; ranks #3 of 14, 85th percentile), supporting that the lab handles a spectrum of level I–V examinations.

Cytopathology and adequacy services appear present but are secondary revenue contributors. Codes such as 88173 (1.4K claims, $227.4K, 6.0% of Medicaid revenue; ranks #6 of 12, 55th percentile) and 88172 (715 claims, $41.5K, 1.1% of Medicaid revenue; ranks #7 of 10, 33th percentile) indicate onsite fine-needle-aspirate analysis and immediate adequacy assessment workflows consistent with integrated cytology support.

Immunohistochemistry and specialized single-antibody stains are used sparingly relative to peers, implying limited IHC throughput or outsourcing of high-complexity stains. For example, 88341 shows only 48 claims ($19.3K, 0.5% of Medicaid revenue) and ranks #11 of 11 in-state (0th percentile), while 88342 has 40 claims ($2.9K, 0.1% of Medicaid revenue) and ranks #14 of 15 (7th percentile); both are described as "typical, unremarkable volume for this code," but their low ranks flag constrained IHC activity versus other Puerto Rico providers.

The combination of a ~20-year NPI history, concentrated Medicaid revenue ($3.8M) with no Medicare billing on file, and a code mix dominated by 88305/88307/88312 suggests a stable, Medicaid-focused pathology lab with routine surgical pathology throughput. The business profile implies both an opportunity to expand payer diversification (if desired) and a vulnerability to Medicaid reimbursement changes because a small set of surgical-pathology services drives the majority of revenue.

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	17,990	$80	$1.3M
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	5,610	$200	$1.1M
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	4,870	$120	$599.3K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	7,920	$30	$245.6K
88173	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate and then interprets and reports the results.	1,440	$160	$227.4K
88302	The physician, typically a pathologist, performs a level II examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	3,820	$40	$149.1K
88172	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate immediately after aspiration to determine whether a sample satisfactory for diagnosis…	720	$60	$41.5K
88311	The lab analyst performs a decalcification procedure on a specimen. Dissolving the calcium makes it easier to perform certain examinations.	1,640	$20	$26.2K
88108	The analyst prepares smears of cytopathology fluids, washings, or brushings, except for cervical or vaginal fluid, using a concentration technique and interprets his findings. Cytopathology is the…	420	$50	$20.3K
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	50	$400	$19.3K

Showing 1–10 of 13

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

Arecibo Pathology Services Csp — 0 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	7	30	4,250	$80	$1.3M
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	11	10	1,420	$300	$1.2M
88307	The physician, typically a pathologist, performs a level V examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4	20	1,210	$190	$535.5K
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	5	30	1,210	$150	$530.3K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	14	20	2,030	$80	$485.9K
88173	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate and then interprets and reports the results.	6	10	1,220	$120	$238.7K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	4	20	2,660	$30	$123.8K
88172	The lab analyst performs the technical lab test to analyze a cytopathology specimen from a fine needle aspirate immediately after aspiration to determine whether a sample satisfactory for diagnosis…	7	10	1,290	$60	$117.6K
88309	The physician, typically a pathologist, performs a level VI examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	5	10	90	$310	$65.2K
88302	The physician, typically a pathologist, performs a level II examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	3	10	960	$40	$64.9K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fidel De Frias Jimenez	PR	Anatomic Pathology & Clinical Pathology Physician	$5.5K	$3.3M
Jose Santiago Alvarado	PR	Anatomic Pathology & Clinical Pathology Physician	$17.2K	$3.2M
Katherine Davila	PR	Clinical Pathology Physician	$1.2K	$104.8K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mennonite General Hospital Inc	PR	Specialist	$0	$8.3M
Sandra Gracia-lopez	PR	Nuclear Medicine Physician	$26.7K	$4.1M
Mennonite General Hospital Inc	PR	General Acute Care Hospital	$0	$2.8M
Clinica Oftalmica De La Montana, C.s.p.	PR	Exclusive Provider Organization	$0	$2M
Marie Lugo	PR	Sports Medicine (Physical Medicine & Rehabilitation) Physician	$1.1K	$1.7M
Vital-care Medical Center L.L.C.	PR	Multi-Specialty Clinic/Center	$0	$1.3M
Carlene Cadiz Fuentes	PR	Obstetrics & Gynecology Physician	$0	$1.2M
Juan Raya	PR	General Practice Physician	$0	$1.1M
Clinica De Manejo Del Dolor Dr Crawford W Long C S P	PR	Pain Medicine (Anesthesiology) Physician	$0	$1M
Nestor Sanchez Colon	PR	Dermatopathology Physician	$34.6K	$992.5K

Arecibo Pathology Services Csp — Billing Profile & Reimbursement Data

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Arecibo Pathology Services Csp — 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