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.

Mervin Figueroa-pinto (NPI 1891928123)

Field	Value
Entity Type	Individual
Organization	Mervin Figueroa-pinto
Address	Chalets De La Fuente 5
City	Carolina
State	PR
ZIP	00987
Taxonomy	Gastroenterology Physician
NPI Enumerated	September 3, 2009

Payer Source	Total Paid
Medicaid	$1.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	1,100	$500	$552.9K
43251	An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. The physician removes one or more lesions using a snare…	1,060	$280	$293.6K
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.	1,050	$250	$267.2K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	1,090	$240	$258.6K
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…	2,200	$50	$99K
99203	The provider sees a new 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 provider…	1,130	$50	$59.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$50	$1.3K

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

Mervin Figueroa-pinto — 1 of 7 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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
43251	An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. The physician removes one or more lesions using a snare…	1	10	550	$270	$149.5K
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.	20	110	270	$280	$148.1K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	3	40	110	$500	$143.4K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	8	80	200	$250	$83.6K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	409	500	130	$90	$43.1K
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…	712	3,230	330	$10	$42.4K
99203	The provider sees a new 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 provider…	202	1,400	160	$50	$29.6K

Nearby Providers

Other providers in the same ZIP code as Mervin Figueroa-pinto, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vimar Therapy Group Inc	PR	Clinic/Center	$0	$16.8M
Laboratorio Clinico Parque Escorial	PR	Clinical Medical Laboratory	$22.8K	$1.4M
Emergency Medical Inc	PR	Land Ambulance	$23.6K	$276.4K
Evolution Ambulance Inc.	PR	Land Ambulance	$13.4K	$196.9K
Walgreen Co	PR	Pharmacy	$95.6K	$0
Thaer Abukhalil	PR	Emergency Medicine Physician	$63K	$0
Hector Santos	PR	Neurology Physician	$25.2K	$0
Caribe Pharmacy Management LLC	PR	Community/Retail Pharmacy	$23.8K	$0
Salvador Ribot Ruiz	PR	General Practice Physician	$210	$0

Mervin Figueroa-pinto — Billing Profile & Reimbursement Data

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Mervin Figueroa-pinto — 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