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.

Instituto De Gastroenterologia De P.r. (NPI 1942294012)

Field	Value
Entity Type	Organization
Organization	Instituto De Gastroenterologia De P.r.
Address	400 Ave F.d. Roosevelt Ave.
City	San Juan
State	PR
ZIP	00918
Taxonomy	Gastroenterology Physician
NPI Enumerated	September 6, 2005

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	3,060	$310	$940K
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…	7,860	$50	$384.9K
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…	2,630	$90	$223.6K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	420	$260	$108.2K
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…	290	$260	$74.4K
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,…	460	$30	$15.7K
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…	30	$540	$13.6K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	40	$50	$2K

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

Instituto De Gastroenterologia De P.r. — 2 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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	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…	34	40	110	$500	$143.4K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	18	50	160	$220	$84.5K
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…	31	80	200	$250	$83.6K
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…	244	3,230	330	$10	$42.4K
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…	7	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,…	374	840	340	$1	$16.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	210	320	130	$20	$12.7K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Instituto De Gastroenterologia De P.r., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Instituto De Gastroenterologia De Pr	PR	Endoscopy Clinic/Center	$33.6K	$0
Myriam Villafana-suarez	PR	Gastroenterology Physician	$22.1K	$0
Fernando Ramos-mercado	PR	Gastroenterology Physician	$11.5K	$0
Joanne Marin	PR	Diagnostic Radiology Physician	$10.4K	$0
Luis Melendez-morales	PR	Vascular & Interventional Radiology Physician	$6.8K	$0

Nearby Providers

Other providers in the same ZIP code as Instituto De Gastroenterologia De P.r., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratorio De Patologia Dr Noy	PR	Anatomic Pathology Physician	$0	$45.7M
Hato Rey Pathology Associates Inc	PR	Clinical Medical Laboratory	$58.5K	$42M
Home Orthopedics Corp	PR	Prosthetic/Orthotic Supplier	$0	$20.7M
Orthobone, Inc	PR	Customized Equipment (DME)	$0	$15.5M
Smith & Nephew Inc.	PR	Prosthetic/Orthotic Supplier	$0	$12M
Laboratorio Clinico Noy Inc	PR	Clinical Medical Laboratory	$76.1K	$9.9M
Servicios Radiologicos Asociados Jorge Perez Brais	PR	Diagnostic Radiology Physician	$0	$2.9M
Luis Torres Vera	PR	Allergy Physician	$21.5K	$2.7M
Inspira Psychiatric Services Psc	PR	Adult Mental Health Clinic/Center	$0	$2.5M
Frankie Alvarado	PR	Pulmonary Disease Physician	$7.3K	$2.4M

Instituto De Gastroenterologia De P.r. — Billing Profile & Reimbursement Data

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Instituto De Gastroenterologia De P.r. — 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