Puerto Rico Data
21 Awardees
| Line | Payer Category | Charges | Collections | |||||
|---|---|---|---|---|---|---|---|---|
| Full Charges This Period (a) $ |
% of Payer | % of Total | Amount Collected This Period (b) $ |
% of Payer | % of Total | % of Charges | ||
| 1. | Medicaid Non-Managed Care | $11,937,107 | 2.74% | 1.82% | $6,869,745 | 1.77% | 1.29% | 57.55% |
| 2a. | Medicaid Managed Care (capitated) | $191,447,242 | 43.91% | 29.26% | $208,292,085 | 53.79% | 39.18% | 108.80% |
| 2b. | Medicaid Managed Care (fee-for-service) | $232,637,845 | 53.35% | 35.56% | $172,090,014 | 44.44% | 32.37% | 73.97% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $436,022,194 | 100.00% | 66.65% | $387,251,844 | 100.00% | 72.84% | 88.81% |
| 4. | Medicare Non-Managed Care | $10,938,904 | 8.40% | 1.67% | $6,289,004 | 6.43% | 1.18% | 57.49% |
| 5a. | Medicare Managed Care (capitated) | $34,216,814 | 26.26% | 5.23% | $27,290,964 | 27.88% | 5.13% | 79.76% |
| 5b. | Medicare Managed Care (fee-for-service) | $85,122,331 | 65.34% | 13.01% | $64,294,375 | 65.69% | 12.09% | 75.53% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $130,278,049 | 100.00% | 19.91% | $97,874,343 | 100.00% | 18.41% | 75.13% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | 0.00% | $0 | 0.00% | |||
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $0 | 0.00% | $0 | 0.00% | |||
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $0 | 0.00% | $0 | 0.00% | |||
| 9. | Total Other Public (specify _______) (Sum of Lines 7 + 8a + 8b) | $0 | 0.00% | $0 | 0.00% | |||
| 10. | Private Non-Managed Care | $53,731,394 | 100.00% | 8.21% | $28,073,573 | 100.00% | 5.28% | 52.25% |
| 11a. | Private Managed Care (capitated) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 11b. | Private Managed Care (fee-for-service) | $0 | 0.00% | 0.00% | $0 | 0.00% | 0.00% | |
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $53,731,394 | 100.00% | 8.21% | $28,073,573 | 100.00% | 5.28% | 52.25% |
| 13. | Self-Pay | $34,199,557 | 100.00% | 5.23% | $18,447,871 | 100.00% | 3.47% | 53.94% |
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $654,231,194 | 100.00% | $531,647,631 | 100.00% | 81.26% | ||
| Line | Payer Category | Retroactive Settlements, Receipts, and Paybacks(c) | Adjustments | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Collection of Reconciliation /Wraparound Current Year(c1) $ |
Collection of Reconciliation /Wraparound Previous Years(c2) $ |
Collection of Other Payments: P4P, Risk Pools, etc.(c3) $ |
Penalty/ Payback (c4) $ |
Net Retros $ |
Net Retros % of Charges | Adjustments (d) $ |
Adjustments % of Charges | ||
| 1. | Medicaid Non-Managed Care | $0 | $0 | $0 | $0 | $0 | 0.00% | $4,155,055 | 34.81% |
| 2a. | Medicaid Managed Care (capitated) | $82,004,668 | $21,361,826 | $3,028,251 | $681 | $106,394,064 | 55.57% | ($16,844,843.00) | -8.80% |
| 2b. | Medicaid Managed Care (fee-for-service) | $3,506,060 | $2,201,375 | $364,295 | $251 | $6,071,479 | 2.61% | $50,738,517 | 21.81% |
| 3. | Total Medicaid (Sum of Lines 1 + 2a + 2b) | $85,510,728 | $23,563,201 | $3,392,546 | $932 | $112,465,543 | 25.79% | $38,048,729 | 8.73% |
| 4. | Medicare Non-Managed Care | $0 | $0 | $0 | $0 | $0 | 0.00% | $1,866,587 | 17.06% |
| 5a. | Medicare Managed Care (capitated) | $0 | $0 | $102,066 | $478 | $101,588 | 0.30% | $6,925,850 | 20.24% |
| 5b. | Medicare Managed Care (fee-for-service) | $0 | $0 | $208,752 | $415 | $208,337 | 0.24% | $13,242,912 | 15.56% |
| 6. | Total Medicare (Sum of Lines 4 + 5a + 5b) | $0 | $0 | $310,818 | $893 | $309,925 | 0.24% | $22,035,349 | 16.91% |
| 7. | Other Public, including Non-Medicaid CHIP, Non-Managed Care | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 8a. | Other Public, including Non-Medicaid CHIP, Managed Care (capitated) | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 8b. | Other Public, including Non-Medicaid CHIP, Managed Care (fee-for-service) | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 9. | Total Other Public (specify _______) (Sum of Lines 7 + 8a + 8b) | $0 | $0 | $0 | $0 | $0 | $0 | ||
| 10. | Private Non-Managed Care | $86,487 | $1,040 | $85,447 | 0.16% | $15,157,078 | 28.21% | ||
| 11a. | Private Managed Care (capitated) | $0 | $0 | $0 | $0 | ||||
| 11b. | Private Managed Care (fee-for-service) | $0 | $0 | $0 | $0 | ||||
| 12. | Total Private (Sum of Lines 10 + 11a + 11b) | $86,487 | $1,040 | $85,447 | 0.16% | $15,157,078 | 28.21% | ||
| 13. | Self-Pay | ||||||||
| 14. | TOTAL (Sum of Lines 3 + 6 + 9 + 12 + 13) | $85,510,728 | $23,563,201 | $3,789,851 | $2,865 | $112,860,915 | 17.25% | $75,241,156 | 11.50% |
| Line | Sliding Fee Discounts (e) $ |
Bad Debt Write-Off (f) $ |
|
|---|---|---|---|
| 13. | Self-Pay | $10,035,543 | $2,119,167 |
Footnotes
'-' Data cannot be calculated or has been suppressed for confidentiality purposes.
'**' Patient Support Services are listed as Enabling Services in the 2025 UDS Manual.
Cells that are shaded blue represent data that was not reported or null values.
View Detailed UDS Footnotes
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