Medicare provider payments and utilization data for Puerto Rico (PR)
Puerto Rico received $866.2M in total Medicare provider payments across 10 years of data.
The top specialty by spending is Centralized Flu, accounting for $6.2M in payments across 85 providers.
In 2023, 3.7K providers were actively billing Medicare in Puerto Rico.
Annual Medicare spending declined 48% from 2014 to 2023.
AI-generated analysis based on Medicare payment data.
| Year | Payments | Services | Providers | YoY Change |
|---|---|---|---|---|
| 2014 | $106.6M | 3.5M | 5.4K | — |
| 2015 | $98.7M | 3.2M | 5.3K | -7.4% |
| 2016 | $96.3M | 3.1M | 5.3K | -2.5% |
| 2017 | $84.0M | 2.5M | 5.0K | -12.7% |
| 2018 | $95.5M | 2.7M | 4.9K | +13.6% |
| 2019 | $97.4M | 2.7M | 4.8K | +2.1% |
| 2020 | $74.1M | 2.2M | 4.3K | -24.0% |
| 2021 | $91.0M | 2.8M | 4.4K | +22.8% |
| 2022 | $67.4M | 2.8M | 3.9K | -25.9% |
| 2023 | $55.2M | 2.1M | 3.7K | -18.1% |
| Code | Description | Payments | Services | Providers |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | $6.4M | 109.9K | 1.5K |
| K1034 | Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count | $6.1M | 521.3K | 140 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | $3.1M | 37.7K | 474 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | $1.7M | 28.6K | 218 |
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | $1.6M | 17.9K | 167 |
| 99285 | Emergency department visit with high level of medical decision making | $1.1M | 8.0K | 69 |
| 66984 | Removal of cataract with insertion of prosthetic lens | $986.1K | 1.9K | 41 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | $975.1K | 7.4K | 199 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | $867.0K | 11.9K | 475 |
| 93306 | Ultrasound of heart with color-depicted blood flow, rate, direction and valve function | $703.0K | 6.2K | 164 |
| 92012 | Established patient problem focused exam of visual system | $639.7K | 11.0K | 148 |
| J0897 | Injection, denosumab, 1 mg | $621.1K | 34.2K | 2 |
| 99291 | Critical care, first 30-74 minutes | $618.0K | 3.6K | 69 |
| A0429 | Ambulance service, basic life support, emergency transport (bls-emergency) | $608.3K | 1.9K | 49 |
| 99284 | Emergency department visit with moderate level of medical decision making | $591.5K | 6.4K | 127 |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | $559.8K | 11.6K | 54 |
| 84443 | Blood test, thyroid stimulating hormone (tsh) | $544.8K | 33.2K | 321 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | $532.2K | 4.7K | 199 |
| 80061 | Blood test, lipids (cholesterol and triglycerides) | $512.2K | 39.8K | 336 |
| 36415 | Insertion of needle into vein for collection of blood sample | $472.6K | 75.6K | 382 |
| Specialty | Payments | Providers | Avg per Provider |
|---|---|---|---|
| Centralized Flu | $6.2M | 85 | $73.3K |
| Clinical Laboratory | $5.1M | 387 | $13.2K |
| Internal Medicine | $4.6M | 381 | $12.1K |
| Cardiology | $3.1M | 206 | $15.0K |
| Ophthalmology | $2.9M | 171 | $16.7K |
| Diagnostic Radiology | $2.7M | 161 | $16.6K |
| Physical Medicine and Rehabilitation | $2.2M | 105 | $21.0K |
| Emergency Medicine | $2.0M | 97 | $20.2K |
| General Practice | $1.8M | 306 | $5.7K |
| Ambulance Service Provider | $1.6M | 84 | $19.4K |
| Dermatology | $1.6M | 72 | $22.3K |
| Nephrology | $1.5M | 84 | $18.4K |
| Pulmonary Disease | $1.4M | 90 | $15.1K |
| Hematology-Oncology | $1.3M | 63 | $20.7K |
| Neurology | $1.3M | 85 | $15.3K |
| Nuclear Medicine | $1.1M | 19 | $58.2K |
| Physical Therapist in Private Practice | $1.1M | 67 | $16.1K |
| Ambulatory Surgical Center | $968.3K | 17 | $57.0K |
| Gastroenterology | $937.2K | 119 | $7.9K |
| Otolaryngology | $840.7K | 49 | $17.2K |
| Pathology | $835.8K | 53 | $15.8K |
| Infectious Disease | $824.4K | 58 | $14.2K |
| Orthopedic Surgery | $811.3K | 84 | $9.7K |
| Family Practice | $806.2K | 80 | $10.1K |
| Endocrinology | $714.3K | 71 | $10.1K |
Last Updated: February 2026 (data through 2023, the latest CMS release)
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.