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.

Mediko Imaging Inc. (NPI 1831205236)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mediko Imaging Inc.
Address	Ave. Jose Villares
City	Caguas
State	PR
ZIP	00725
Taxonomy	Radiology Clinic/Center
NPI Enumerated	August 21, 2006

Payer Source	Total Paid
Medicaid	$6.8M
Medicare	$0

MEDIKO IMAGING INC. is an NPI-enumerated Radiology Clinic/Center in CAGUAS, PR (enumerated on 2006-08-21, ~20 years ago) with $6.8M in lifetime Medicaid revenue and no Medicare billing on file; operationally this makes the practice effectively single-payer (Medicaid) in scope for the available claims data.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 43.5% of the provider’s total Medicaid revenue, led by 76641 ($1.3M, 19.2%), followed by 77066 ($832.6K, 12.3%) and 77067 ($809.4K, 11.9%). These three breast imaging codes are the dominant revenue drivers for the practice.

The CPT mix indicates a specialization in high-volume breast imaging and diagnostic ultrasound. High-revenue/big-volume codes include breast ultrasound and diagnostic mammography (76641, 77066, 77067) alongside a broad set of ultrasound services such as 76700 (abdominal), 76830 (transvaginal), 76856 (pelvic) and 76536 (head/neck soft tissue), implying a full-service outpatient imaging workflow that handles screening, diagnostic mammography, and many general ultrasound exams.

State-level competitive standing is dominant for multiple codes: 76641 ranks #2 of 183 providers in-state (99th percentile; extreme outlier) and 77066 ranks #3 of 133 (98th percentile; extreme outlier), while abdominal and pelvic ultrasound codes such as 76700 (#2 of 225, 100th percentile; extreme outlier) and 76856 (#1 of 157, 100th percentile; extreme outlier) also indicate top-tier statewide volume. These rank/percentile positions mark the provider as a major and unusually high-volume Medicaid imaging source in Puerto Rico for several service lines.

Beyond breast imaging, the provider shows a large ultrasound footprint: 76700 reports 9.5K claims and $723.3K revenue (10.7%), 76830 reports 6.9K claims and $548.9K revenue (8.1%), 76536 reports 7.6K claims and $517.8K revenue (7.6%), and 76881 reports 7.9K claims and $480.6K revenue (7.1%); many of these codes are ranked at or near the top of in-state peers and are labeled as extreme outlier or notably above typical state volume, reinforcing a high-throughput ultrasound operation.

The provider also maintains a substantial portfolio of plain radiography and musculoskeletal/spine imaging: 71046 (8.8K claims, $185.7K, 2.7%) and 72100 (6.6K claims, $164K, 2.4%) and 73560 (5.8K claims, $128.3K, 1.9%) are all high-claim lines where the provider ranks well above most in-state peers, suggesting diversified revenue sources beyond breast imaging and ultrasound.

Being effectively Medicaid-only with $6.8M of Medicaid revenue and no Medicare billing on file concentrates payer exposure to state/Medicaid policy and Medicaid Managed Care Organization contracting; this concentration raises commercial/payer diversification risk and makes changes in Medicaid reimbursement or referral patterns a material business risk for the facility.

Operational scale signals are strong: very high claim counts on individual codes (for example 13.9K claims for 76641, 9.5K claims for 76700, and 9.3K claims for 77067) combined with ~20 years of NPI tenure suggest an established, high-throughput outpatient imaging center with sustained Medicaid referral flow and capacity across mammography, ultrasound, and general radiography services.

Medicaid: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	13,850	$90	$1.3M
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…	6,880	$120	$832.6K
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…	9,300	$90	$809.4K
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…	9,520	$80	$723.3K
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.	6,860	$80	$548.9K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	7,610	$70	$517.8K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	7,880	$60	$480.6K
76856	A pelvic ultrasound is a noninvasive procedure used to assess body parts such as the bladder, ovaries, uterus, cervix, and fallopian tubes in females and the bladder, prostate gland, and seminal…	4,800	$70	$335.9K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	2,850	$70	$211K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	8,840	$20	$185.7K

Showing 1–10 of 39

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

Mediko Imaging Inc. — 18 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

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	18	20	910	$110	$303K
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…	7	150	1,180	$70	$170.3K
76641	In this procedure, the provider performs a complete ultrasound of one breast. The procedure includes documentation of the images.	2	180	890	$70	$145.5K
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…	3	130	480	$90	$109.4K
76881	In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is…	1	30	950	$60	$96.9K
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…	2	230	510	$60	$61K
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.	3	220	290	$60	$47.2K
76536	The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.	2	170	310	$60	$46.5K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	20	260	850	$10	$27.8K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	92	120	130	$60	$26.9K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio Clinico Borinquen, Inc	PR	Clinical Medical Laboratory	$1.4M	$37.1M
Msl Therapeutical Services, Psc	PR	Occupational Therapist	$0	$12.8M
Laboratorio Clinico Bairoa Inc	PR	Clinical Medical Laboratory	$271.3K	$11.3M
Centro Medico Del Turabo Inc	PR	Multi-Specialty Clinic/Center	$0	$10.8M
Consolidated Radiology Complex Csp	PR	Radiology Clinic/Center	$0	$6.8M
Caribbean Heart Institute LLC	PR	Clinical Cardiac Electrophysiology Physician	$0	$5.7M
Nuscan Csp	PR	Nuclear Medicine Physician	$0	$5.5M
Conmed Laboratories Inc	PR	Clinical Medical Laboratory	$105.5K	$5.4M
Sps Specialty Pharmacy Services Inc	PR	Specialty Pharmacy	$0	$4.2M
Advanced Hematology And Oncology Of Puerto Rico	PR	Hematology & Oncology Physician	$0	$3.6M

Mediko Imaging Inc. — Billing Profile & Reimbursement Data

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Mediko Imaging 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

Nearby Providers

Frequently Asked Questions

References