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.

Centro De Especialistas Pediatricos (NPI 1851457774)

Centro De Especialistas Pediatricos is a specialist provider located in Caguas, Puerto Rico. This profile covers 0 Medicare and 9 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	Centro De Especialistas Pediatricos
Address	D3 Ave Degetau
City	Caguas
State	PR
ZIP	00725
Taxonomy	Specialist
NPI Enumerated	December 28, 2006

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	9,640	$50	$510.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	7,160	$60	$451K
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…	2,930	$100	$278.5K
94200	The provider measures the largest volume of air that a patient can voluntarily breathe while the patient breathes as deeply and quickly as possible for a specified period of time. This test helps…	9,630	$20	$154K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	1,270	$70	$91.7K
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…	720	$120	$85.2K
94664	The provider educates a patient on the use of an aerosol device, nebulizer, metered dose inhaler, or IPPB device and then has the patient demonstrate her understanding. He does this as part of the…	4,530	$10	$45.3K
94760	The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger.	2,680	$10	$13.4K
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,…	20	$30	$770

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

Centro De Especialistas Pediatricos — 4 of 9 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	2	30	350	$50	$75.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	14	280	210	$30	$43.8K
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…	101	900	360	$30	$42.5K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	12	160	90	$90	$31.8K
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…	61	530	100	$70	$22.9K
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,…	716	840	340	$1	$16.7K
94200	The provider measures the largest volume of air that a patient can voluntarily breathe while the patient breathes as deeply and quickly as possible for a specified period of time. This test helps…	1	20	140	$20	$16.7K
94664	The provider educates a patient on the use of an aerosol device, nebulizer, metered dose inhaler, or IPPB device and then has the patient demonstrate her understanding. He does this as part of the…	2	60	170	$10	$5.3K
94760	The provider takes a single measurement of the patient’s oxygen saturation using a sensor on the ear or finger.	4	50	160	$1	$2K

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
Mediko Imaging Inc.	PR	Radiology Clinic/Center	$0	$6.8M
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

Centro De Especialistas Pediatricos — Billing Profile & Reimbursement Data

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Centro De Especialistas Pediatricos — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References