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.

Carlene Cadiz Fuentes (NPI 1912249897)

Carlene Cadiz Fuentes is a obstetrics & gynecology physician provider located in Aibonito, Puerto Rico. This profile covers 0 Medicare and 23 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	Individual
Organization	Carlene Cadiz Fuentes
Address	100 Calle Jose C Vazquez
City	Aibonito
State	PR
ZIP	00705
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	March 19, 2013

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	9,400	$50	$432.6K
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…	2,510	$60	$140.3K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	90	$1,320	$119K
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,…	3,210	$40	$115.4K
58558	The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples…	100	$1,130	$113.1K
G0101	Cervical or vaginal cancer screening; pelvic and clinical breast examination	4,030	$30	$112.9K
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.	370	$100	$37.3K
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…	630	$50	$30.2K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	200	$70	$13K
57454	In this procedure, the provider examines the cervix, including the upper/adjacent portion of the vagina, using an instrument called a colposcope, and also performs biopsy(s) of the cervix and…	60	$190	$12.3K

Showing 1–10 of 23

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

Carlene Cadiz Fuentes — 1 of 23 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	4	10	80	$1,450	$151.2K
58558	The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples…	8	20	50	$590	$105.5K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	15	30	210	$60	$53.9K
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.	93	220	290	$60	$47.2K
57454	In this procedure, the provider examines the cervix, including the upper/adjacent portion of the vagina, using an instrument called a colposcope, and also performs biopsy(s) of the cervix and…	6	10	60	$140	$42.8K
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…	343	900	360	$30	$42.5K
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…	209	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…	73	1,400	160	$50	$29.6K
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…	62	120	130	$60	$26.9K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	8	20	190	$20	$26.3K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mennonite General Hospital Inc	PR	Specialist	$0	$8.3M
Mennonite General Hospital Inc	PR	General Acute Care Hospital	$0	$2.8M
Wilfredo De Jesus Rojas	PR	Pediatric Pulmonology Physician	$0	$1.2M
Jorge Colon Martinez	PR	General Practice Physician	$0	$729.7K
Pedro Perez	PR	General Practice Physician	$0	$668K
Fabio Ricci Gorbea	PR	Internal Medicine Physician	$2.1K	$630.9K
Walisbeth Class-vazquez	PR	Gastroenterology Physician	$7.7K	$492.6K
Jesus Rodriguez Rodriguez	PR	General Practice Physician	$6.6K	$224.2K
Juan Malpica-santiago	PR	Pulmonary Disease Physician	$33.2K	$148.3K
Jeffrey Zuckerman	PR	Diagnostic Radiology Physician	$131.1K	$2.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sandra Gracia-lopez	PR	Nuclear Medicine Physician	$26.7K	$4.1M
Arecibo Pathology Services Csp	PR	Anatomic Pathology & Clinical Pathology Physician	$0	$3.8M
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
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
Janice Del C Rolon Marrero	PR	Clinical Medical Laboratory	$2.2K	$951.2K
Jose Garcia	PR	Cardiovascular Disease Physician	$7.5K	$939.7K

Carlene Cadiz Fuentes — Billing Profile & Reimbursement Data

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Carlene Cadiz Fuentes — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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