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.

Risa Nielsen (NPI 1083621742)

Field	Value
Entity Type	Individual
Organization	Risa Nielsen
Address	Beeston Hill Medical Center
City	St Croix
State	VI
ZIP	00820
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 2, 2006

Payer Source	Total Paid
Medicare	$67.9K
Medicaid	$0

Key Findings

RISA NIELSEN is listed as an Internal Medicine physician with an NPI enumerated 2006-08-02 (~20 years ago). Her lifetime Medicare revenue on file is $67.9K and there is no Medicaid billing on file, making her effectively a single-payer (Medicare-only) billing profile in these datasets. This tenure suggests a long-established clinician-level practice rather than a newly entered provider.

Revenue is highly concentrated in three office-visit and preventive codes: 99214 ($32.1K, 47.3% of Medicare revenue), G0439 ($15.5K, 22.8%), and 99213 ($12.2K, 18.0%); these top three codes account for 88.1% of the provider’s total Medicare revenue. That concentration indicates the business is dominated by routine evaluation-and-management and annual wellness activity rather than procedure-based revenue streams.

The code-level mix (dominant 99214 and 99213 E/M visits plus G0439 annual wellness visits) points to a primary care/longitudinal outpatient practice model focused on established-patient management and preventive care. Claim volumes and average payments reflect this: 99214 shows 411 claims at $78 avg paid/claim, 99213 shows 244 claims at $50 avg paid/claim, and G0439 shows 121 claims at $128 avg paid/claim, consistent with steady ambulatory visit throughput.

Preventive services and screenings are a material part of the profile: G0439 (annual wellness visits) is $15.5K across 121 claims and G0444 (depression screening) is 112 claims for $2K; vaccination codes also appear (90694: 30 claims, $2.2K; G0008: 56 claims, $1.7K; 90674: 27 claims, $864). Together these codes reinforce that preventive and population-health activities are an operational emphasis alongside routine chronic disease follow-up.

Competitive standing by code is mixed but generally within typical ranges: 99214 ranks #66503 of 479517 providers (86th percentile) and 99213 ranks #77934 of 457151 providers (83th percentile), both flagged in the source as "typical, unremarkable volume for this code," which indicates above-average national placement on rank metrics without being an extreme outlier. G0439 ranks #26621 of 105855 providers (75th percentile) and is likewise described as "typical, unremarkable volume," signaling moderate national activity in annual wellness visits.

Lower-volume items such as vaccine administration and ECGs sit at more modest percentiles: 90694 ranks in the 32th percentile and 93000 in the 34th percentile (both described in the source as "typical, unremarkable volume"), demonstrating the practice is not a high-volume immunization or procedure hub in national comparisons. These lower percentiles align with the overall revenue profile being driven by E/M and wellness codes rather than procedural services.

The small absolute Medicare total ($67.9K) combined with no Medicaid billing on file suggests a compact Medicare patient panel or limited Medicare-facing throughput; this makes overall revenue sensitive to changes in utilization or reimbursement for core E/M and wellness codes. For payer mix analysis, this profile should be treated as effectively single-payer (Medicare) with minimal to no Medicaid presence.

From an operational and network-coverage perspective, the provider’s record—long tenure, concentrated E/M/wellness revenue, and typical national ranking on key primary-care codes—suggests a stable, community-based internal medicine practice focused on routine outpatient care rather than specialty procedures or broad multi-payer contracting. Analysts evaluating competitive positioning should expect this provider to compete on longitudinal primary-care services rather than procedural volume or Medicaid-focused care.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

9 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…	410	$80	$32.1K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	120	$130	$15.5K
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…	240	$50	$12.2K
90694	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is an inactivated, adjuvanted, preservative–free vaccine given as a 0.5 mL…	30	$70	$2.2K
G0444	Annual depression screening, 5 to 15 minutes	110	$20	$2K
G0008	Administration of influenza virus vaccine	60	$30	$1.7K
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…	10	$100	$1.2K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	30	$30	$860
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…	20	$10	$180

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. U.S. Virgin Islands Distribution

Risa Nielsen — 1 of 9 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. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	12	80	100	$80	$15.5K
G0439	3	20	60	$120	$8.1K
99213	17	80	100	$50	$7.6K
99204	33	40	40	$100	$4.4K
90694	3	10	30	$70	$3.3K
G0008	6	10	50	$30	$1.7K
93000	12	20	30	$10	$1.3K
G0444	1	10	50	$20	$1K
90674	1	10	30	$30	$870

Nearby Providers

Other providers in the same ZIP code as Risa Nielsen, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Croix Vision Center Inc	VI	Optometrist	$0	$3.6M
One Dental Practice LLC	VI	Dentist	$0	$3.2M
Governor Juan F. Luis Hospital & Medical Center	VI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$3M
Js Therapies, LLC	VI	Occupational Therapist	$0	$2.9M
Healthquest, LLC.	VI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$2.4M
Department Of Health, Ems Stx	VI	Land Ambulance	$0	$2.2M
Lindsy Wagner LLC	VI	Clinical Social Worker	$0	$2.2M
Ophthalmology Consultants, PC	VI	Ophthalmology Physician	$0	$2.1M
Acute Alternative Medical Group	VI	Emergency Medical Services (Emergency Medicine) Physician	$0	$1.9M
Pediatric Care Center LLC	VI	Pediatrics Physician	$0	$1.7M

Risa Nielsen — Billing Profile & Reimbursement Data

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Risa Nielsen — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References