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NPI 1952405425 · Ponce, PR · Hematology & Oncology Physician
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Hector Velez Cortes is a hematology & oncology physician provider located in Ponce, Puerto Rico. This profile covers 1 Medicare and 24 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Hector Velez Cortes |
| Address | 1217 Ave Hostos |
| City | Ponce |
| State | PR |
| ZIP | 00717 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | September 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4M |
| Medicare | $4.3K |
Payer mix is heavily skewed to Medicaid: this provider reports $4M in total Medicaid revenue compared with only $4.3K in total Medicare revenue, making Medicaid effectively the dominant payer by scale for this NPI. The Medicare footprint is minimal in dollar terms while Medicaid drives the business economics of the practice.
Medicaid revenue is concentrated in infusion and chemotherapy administration codes: Q0084, 96413, and 96415 together account for 64.1% of this provider's total Medicaid revenue. The top Medicaid codes reflect that one-third of Medicaid revenue is from Q0084 (33.3%) and another 20.0% from 96413, indicating the practice’s core productivity comes from infusion visits and direct chemotherapy administration.
Code-level volumes and descriptions indicate an infusion-centric oncology operation: high-revenue Medicaid codes include Q0084 (chemotherapy administration by infusion), 96413 (chemotherapy administration), 96415 (add-on hourly infusion), plus frequent use of 96367/96366 and 96365. This mix — initial infusion codes and multiple add-on/subsequent-hour codes — is consistent with a center delivering multi-hour IV chemotherapy sessions and multiple concurrent infusions per visit.
Competitive standing within Puerto Rico is strong for chemotherapy administration: Q0084 ranks #2 of 74 providers in-state (99th percentile; extreme outlier) and 96413 ranks #1 of 68 providers in-state (100th percentile; extreme outlier). These rank/percentile positions indicate the provider is a major, high-volume statewide operator for infusion chemotherapy relative to in-state peers.
Several infusion add-on and support codes also show above-typical state volumes — for example 96415 ranks #4 of 55 (94th percentile; notably above typical), 96367 ranks #3 of 46 (96th percentile; notably above typical), and 96366 ranks #2 of 22 (95th percentile; notably above typical). High percentiles across both primary and ancillary infusion codes reinforce that the practice is delivering a high throughput of complex infusion services rather than occasional outpatient oncology visits.
Medicare billing is extremely limited and concentrated: the single Medicare code listed is 99214, which accounts for 100.0% of this provider's Medicare revenue and $4.3K in Medicare revenue overall. That code ranks #294645 of 479517 providers nationally (38th percentile; typical, unremarkable volume), signaling a modest Medicare presence and suggesting the provider’s Medicare business is largely limited to office E/M visits rather than infusion services billed to Medicare at scale.
The provider’s revenue concentration creates operational and payer-concentration exposure: top infusion codes drive the majority of Medicaid revenue (the top three Medicaid codes alone account for 64.1% of Medicaid revenue), while Medicare revenue is entirely represented by a single E/M code (top 3 Medicare codes account for 100.0% of Medicare revenue). Heavy reliance on a small set of infusion-related Medicaid codes means business performance is tightly linked to throughput of chemotherapy sessions and to Medicaid reimbursement dynamics.
Tenure and market positioning are consistent with an established regional infusion practice: the NPI was enumerated on 2006-09-12 (~20 years ago), and sustained high in-state ranks for chemotherapy codes suggest the provider has built and maintained a significant infusion oncology operation in PONCE, PR over an extended period. The long enrollment combined with extreme in-state volumes positions the provider as an established local chemotherapy services provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
1 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 70 | $60 | $4.3K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 1 CPT/HCPCS codes.
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Full comparison — all codes billed, vs. state median
1 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 99214 | 159 | 470 | 50 | $80 | $6.6K |
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
24 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q0084 | Chemotherapy administration by infusion technique only, per visit | 16,690 | $80 | $1.3M |
| 96413 | Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These… | 9,740 | $80 | $789.1K |
| 96415 | In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the… | 5,320 | $80 | $425.4K |
| 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… | 5,870 | $70 | $399K |
| 96367 | The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose… | 7,250 | $30 | $224.7K |
| 96366 | The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease. | 6,860 | $30 | $219.5K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 2,790 | $40 | $122.7K |
| 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… | 2,570 | $40 | $100.3K |
| 99070 | Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,… | 8,160 | $10 | $81.6K |
| 96409 | In this procedure, the provider administers the chemotherapy drug using an intravenous push technique. Use this code when the provider administers a single or initial drug. | 1,200 | $60 | $71.9K |
Showing 1–10 of 24
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
24 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| Q0084 | Chemotherapy administration by infusion technique only, per visit | 2 | 70 | 900 | $80 | $219.9K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 9 | 60 | 240 | $100 | $147.6K |
| 96413 | Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These… | 1 | 70 | 750 | $80 | $138K |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 335 | 390 | 290 | $80 | $96.8K |
| 96415 | In this add on procedure, the provider continues administration of a chemotherapy drug into a vein using an infusion technique. He uses this code to report each additional hour of infusion beyond the… | 4 | 60 | 360 | $80 | $94K |
| 96367 | The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose… | 3 | 50 | 520 | $50 | $82.4K |
| 99070 | Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,… | 8 | 230 | 410 | $40 | $51.9K |
| 96366 | The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease. | 2 | 20 | 350 | $30 | $50.5K |
| 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… | 177 | 500 | 130 | $90 | $43.1K |
| 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… | 39 | 900 | 360 | $30 | $42.5K |
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Other providers in the same ZIP code as Hector Velez Cortes, ranked by combined Medicare and Medicaid revenue.
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