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.

Vega Alta Community Health (NPI 1952338154)

Vega Alta Community Health is a clinical medical laboratory provider located in Vega Alta, Puerto Rico. This profile covers 0 Medicare and 35 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	Organization
Organization	Vega Alta Community Health
Address	Carr 2 Km 30.1
City	Vega Alta
State	PR
ZIP	00692
Taxonomy	Clinical Medical Laboratory
NPI Enumerated	June 26, 2006

Payer Source	Total Paid
Medicaid	$917K
Medicare	$0

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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,…	6,630	$40	$271.8K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	5,400	$20	$124.1K
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…	4,620	$20	$73.9K
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.	4,650	$10	$60.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	4,930	$10	$54.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	6,200	$10	$49.6K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	1,230	$30	$34.3K
86328	The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2…	1,860	$20	$33.5K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	2,610	$10	$26.1K
84436	The lab analyst performs a test to measure the amount of thyroxine, or T4, a hormone that the thyroid gland produces, responsible for growth and developmenttypically. The typical specimen is the…	3,180	$10	$22.3K

Showing 1–10 of 35

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

Vega Alta Community Health — 2 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

35 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,…	46	650	1,260	$40	$93.7K
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…	214	770	2,520	$20	$65.5K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	72	590	1,440	$20	$65.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	165	370	370	$50	$63.3K
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.	215	810	2,350	$10	$52.7K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	122	290	170	$30	$43.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	141	310	190	$30	$43.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	191	790	2,360	$10	$41.9K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	239	850	3,250	$10	$40.5K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	209	650	630	$30	$35.8K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sonrisas Radiantes Dental Clinic(csp)	PR	Dental Clinic/Center	$0	$2.8M
Luis Acosta	PR	Pediatrics Physician	$0	$2.2M
Cdt Centro De Medicina Primaria De Vega Alta Corp	PR	Clinical Medical Laboratory	$0	$2M
Estudio Dental Otero Loperena LLC	PR	General Practice Dentistry	$0	$1.2M
Caribe Dental Gallery	PR	Dental Clinic/Center	$0	$956.2K
Oficina Dental Laser Dr. Nunez, P.s.c.	PR	Dental Clinic/Center	$0	$939.5K
Clinica Dental Dr. Edwin Rosa, Csp	PR	Oral and Maxillofacial Surgery Clinic/Center	$0	$655.1K
Laboratorio Teresita	PR	Clinical Medical Laboratory	$0	$645K
Laboratorio Clinico Caribe Medical Plaza,inc.	PR	Clinical Medical Laboratory	$5.6K	$610.2K
Centro De Medicina Primaria Va	PR	General Practice Physician	$0	$558K

Vega Alta Community Health — Billing Profile & Reimbursement Data

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Vega Alta Community Health — 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