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.

Aco Del Norte LLC (NPI 1942515440)

Field	Value
Entity Type	Organization
Organization	Aco Del Norte LLC
Address	Calle 16 V1
City	Arecibo
State	PR
ZIP	00612
Taxonomy	Health Maintenance Organization
NPI Enumerated	August 10, 2010

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.

87 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…	27,370	$30	$793.6K
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.	4,600	$60	$285.4K
Q0091	Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory	13,710	$10	$164.5K
99442	N/A	94,940	$1	$94.9K
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…	10,540	$10	$52.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	1,540	$30	$49.3K
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…	340	$90	$30.3K
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…	470	$30	$12.2K
99443	N/A	10,030	$1	$10K
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…	3,360	$1	$6.7K

Showing 1–10 of 87

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

Aco Del Norte LLC — 8 of 13 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

87 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
88142	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	36	50	370	$20	$247.3K
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…	3	20	50	$590	$105.5K
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.	6	220	290	$60	$47.2K
99050	In this procedure, the provider renders services to a patient in his office at a time when that office would otherwise be closed.	70	90	1,090	$10	$47K
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…	17	280	210	$30	$43.8K
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…	3	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…	1	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…	1	3,230	330	$10	$42.4K
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…	86	160	90	$90	$31.8K
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	1,400	160	$50	$29.6K

Showing 1–10 of 87

Nearby Providers

Other providers in the same ZIP code as Aco Del Norte LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sociedad De Servicios Neonatales De Arecibo	PR	Neonatal-Perinatal Medicine Physician	$0	$14.3M
Laboratorio Clinico Toledo, LLC	PR	Clinical Medical Laboratory	$83.2K	$11.9M
Metro Pavia At Home, LLC	PR	Home Health Agency	$0	$6.6M
Hospicio La Paz Inc	PR	Community Based Hospice Care Agency	$0	$5.7M
Retina Care Psc	PR	Ophthalmology Physician	$0	$4.3M
Integral Therapy Center	PR	Hearing and Speech Clinic/Center	$0	$3.8M
Luis Montalvo	PR	Ophthalmology Physician	$8K	$3.5M
Laboratorio Clinico Villa Los Santos	PR	Clinical Medical Laboratory	$360	$3.1M
Emergency Physician Providers, LLC	PR	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.8M
Arraiza Radiology Psc	PR	Diagnostic Radiology Physician	$0	$2.8M

Aco Del Norte LLC — Billing Profile & Reimbursement Data

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Aco Del Norte LLC — 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