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.

Prymed Medical Care, Inc (NPI 1881661866)

Field	Value
Entity Type	Organization
Organization	Prymed Medical Care, Inc
Address	Calle 149 Km 13
City	Ciales
State	PR
ZIP	00638
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	March 8, 2006

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

178 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	17,400	$30	$452.3K
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…	63,980	$10	$383.9K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	6,850	$30	$191.9K
D1999	N/A	6,850	$20	$102.7K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2,540	$40	$91.4K
D0120	Periodic oral evaluation - established patient	6,420	$10	$89.9K
0002A	N/A	2,220	$40	$82.3K
0001A	N/A	2,220	$40	$77.8K
D0330	N/A	2,230	$30	$67K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	8,210	$10	$65.7K

Showing 1–10 of 178

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

Prymed Medical Care, Inc — 5 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

178 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	623	650	1,260	$40	$93.7K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	35	340	210	$70	$81.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	218	500	220	$40	$79.5K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	691	770	2,520	$20	$65.5K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	72	120	180	$80	$62.9K
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…	192	230	510	$60	$61K
87590	The lab analyst performs a test for Neisseria gonorrhoeae, a bacteria, using direct nucleic acid probe technique.	72	80	150	$20	$59.4K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	43	990	1,060	$30	$53.1K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	696	810	2,350	$10	$52.7K
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.	182	220	290	$60	$47.2K

Showing 1–10 of 178

Related Providers

Other providers that share a Tax Identification Number (TIN) with Prymed Medical Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Prymed Medical Care, Inc	PR	Clinical Medical Laboratory	$0	$913.8K
Prymed Medical Care Inc	PR	Clinical Medical Laboratory	$0	$817.9K
Prymed Medical Care, Inc	PR	Multi-Specialty Clinic/Center	$0	$785.5K
Jorge Gonzalez	PR	Psychiatry Physician	$5.2K	$0

Nearby Providers

Other providers in the same ZIP code as Prymed Medical Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ronald Aponte Hernandez	PR	General Practice Physician	$0	$622.6K

Prymed Medical Care, Inc — Billing Profile & Reimbursement Data

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Prymed Medical Care, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References