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 U.S. Virgin Islands for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to U.S. Virgin Islands 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. U.S. Virgin Islands (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.

Virgin Island Orthopedics And Sports Medicine P C (NPI 1053390666)

Key Findings

Field	Value
Entity Type	Organization
Organization	Virgin Island Orthopedics And Sports Medicine P C
Address	9149 Estate Thomas
City	St Thomas
State	VI
ZIP	00802
Taxonomy	Specialist
NPI Enumerated	January 12, 2006

Payer Source	Total Paid
Medicaid	$821.4K
Medicare	$0

VIRGIN ISLAND ORTHOPEDICS AND SPORTS MEDICINE P C has no Medicare billing on file and is effectively a single-payer Medicaid biller in the available datasets; lifetime Medicaid revenue on file is $821.4K and total Medicare revenue is listed as none, indicating Medicaid is the primary source of recorded public-payer activity. This single-payer footprint should be considered when comparing network leverage and contracting posture versus providers with mixed Medicare/Medicaid volumes.

Revenue is highly concentrated in a small set of outpatient E/M and therapy codes: the precomputed top three Medicaid codes account for 72.8% of the provider’s total Medicaid revenue, highlighting a narrow set of services driving most Medicaid receipts. Those top codes are dominated by office evaluation and management plus therapeutic exercise, suggesting predictable per-encounter revenue dependency rather than large procedural or inpatient billings.

The highest-revenue Medicaid line is 99213 (office visit, established patient): 5.1K claims, $63 avg paid/claim, $320.2K revenue, representing 39.0% of this provider’s Medicaid revenue and ranking #6 of 41 in-state (88th percentile). This placement indicates the provider delivers a substantial volume of routine established-patient outpatient visits compared with most in-state peers, but it is not a statewide outlier or dominant single source of such visits.

97110 (therapeutic exercise) contributes $173.6K (21.1% of Medicaid revenue) with 3.9K claims and ranks #3 of 9 in-state (75th percentile). The prominence of 97110 alongside 99213 suggests this practice operates an integrated non-operative orthopedic/rehab service line where office-based management is frequently paired with billed therapy sessions, which may reflect bundled or co-located physical therapy capacity.

99203 (new patient E/M, low complexity) is notable at $104K (12.7% of Medicaid revenue) with 1.2K claims and a #2 of 20 in-state rank (95th percentile), described as "notably above typical state volume." That strong ranking for new-patient visits indicates the practice attracts referrals or self-referred new patients at a materially higher rate than most peers, supporting a growth or referral-facing component to its outpatient pipeline.

Several cardiac diagnostic codes appear in the top Medicaid lists (93306 echo with $84.9K, 93000 ECG with $18.3K), and 93306 ranks #1 of 6 in-state (100th percentile). The presence and high in-state rank of 93306 — a 2D transthoracic echocardiography code — is atypical for a pure orthopedics specialty and may reflect either a broader multispecialty service mix, local coding practice patterns, or onsite diagnostic capability that extends beyond core musculoskeletal procedures.

The provider has long tenure in the NPI registry, enumerated on 2006-01-12 (~20 years ago), which supports the interpretation that observed Medicaid volumes represent an established practice rather than a new entrant. Tenure combined with high ranks on select codes (99203, 93306) suggests sustained referral flows and durable service lines within the state market.

For competitive standing across the Medicaid peer set, the practice is a modest-to-strong participant: it ranks in high percentiles for several high-revenue codes (88th percentile for 99213, 95th for 99203, 100th for 93306) but does not uniformly dominate statewide volumes. The mix of top-code rankings points to concentrated strengths in outpatient E/M, therapeutic exercise, and select diagnostics rather than broad dominance across many specialties.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	5,080	$60	$320.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	3,950	$40	$173.6K
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…	1,170	$90	$104K
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…	1,420	$70	$95.1K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	690	$120	$84.9K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	1,830	$10	$18.3K
99204	The provider sees a new 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 provider…	80	$110	$9.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	90	$50	$4.1K
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…	40	$70	$3.1K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	110	$20	$2.7K

Showing 1–10 of 21

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.

Claims Volume vs. U.S. Virgin Islands Distribution

Virgin Island Orthopedics And Sports Medicine P C — 2 of 20 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — U.S. Virgin Islands

Full comparison — all codes billed, vs. U.S. Virgin Islands median

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	15	40	560	$140	$322K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	3	10	2,030	$50	$281.5K
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…	6	40	430	$110	$260.9K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	7	10	520	$100	$237.1K
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…	16	20	200	$150	$93.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1	10	510	$160	$73.8K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	5	10	740	$30	$52.7K
99204	The provider sees a new 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 provider…	13	30	80	$150	$27K
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	20	80	$90	$27K
99442	N/A	3	10	80	$40	$22.5K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ahmet Sayan	VI	Cardiovascular Disease Physician	$179.1K	$0
John Shuster	WA	Orthopaedic Surgery of the Spine Physician	$101.4K	$0
Jeffrey Chase	VI	Sports Medicine (Orthopaedic Surgery) Physician	$88.6K	$0
Carl Wright	VA	Physician Assistant	$51.2K	$570
Tamara Anderson	VI	Nurse Practitioner	$39.7K	$0
Carmen Quinones	VI	Interventional Pain Medicine Physician	$38.2K	$0
Artemio Torres-martinez	PR	Sports Medicine (Orthopaedic Surgery) Physician	$7K	$15.9K
Sayamira Cordero-fontaine	VI	Physical Therapist	$20.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duanne Jones	VI	Public Health Dentistry	$0	$33.2M
Vi Government Hospital And Health Facilities Corp	VI	General Acute Care Hospital	$0	$23.6M
The St Thomas East End Medical Center Corporation	VI	Federal Public Health Clinic/Center	$0	$12.8M
Aac-air Ambulance Caribbean Inc.	VI	Air Ambulance	$2M	$8.6M
Vi Relocation Services And Rentals LLC	VI	Land Ambulance	$0	$6.8M
Alicia Prentice	VI	Home Health Aide	$0	$3.9M
Stretcher Plus, LLC	VI	Non-emergency Medical Transport (VAN)	$0	$2.8M
Cog Restore, LLC	VI	Rehabilitation Clinic/Center	$0	$2.1M
Dept Of Health, Govt Of Vi Ems St Thomas	VI	Land Ambulance	$0	$1.5M
Vi Oral Surgery, Inc	VI	Oral and Maxillofacial Surgery (Dentist)	$0	$1.4M

Virgin Island Orthopedics And Sports Medicine P C — Billing Profile & Reimbursement Data

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Virgin Island Orthopedics And Sports Medicine P C — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References