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.

Myrah Keating Smith Community Health Center (NPI 1144250580)

Key Findings

Field	Value
Entity Type	Organization
Organization	Myrah Keating Smith Community Health Center
Address	3b Sussannaberg Estate
City	St John
State	VI
ZIP	00831
Taxonomy	Clinic/Center
NPI Enumerated	July 3, 2006

Payer Source	Total Paid
Medicaid	$938.1K
Medicare	$0

MYRAH KEATING SMITH COMMUNITY HEALTH CENTER reports no Medicare billing on file and $938.1K in lifetime Medicaid revenue, making it effectively a Medicaid-focused provider in the available dataset rather than a dual-payer operation. This single-payer concentration should be front-of-mind for analysts assessing payer risk and growth opportunity.

Revenue is highly concentrated: the precomputed top three Medicaid codes (99213, 36415, 99212) account for 94.4% of the provider's total Medicaid revenue, with individual contributions of $323.3K (99213, 34.5%), $317.3K (36415, 33.8%), and $244.6K (99212, 26.1%). Such concentration means changes to reimbursement or utilization of any one of these codes would materially move overall revenue.

The code mix implies a primary-care, ambulatory clinic model emphasizing routine established-patient evaluation and management and on-site specimen collection: 99213 and 99212 are the top revenue drivers (routine E/M visits), while 36415 (venipuncture) is nearly as large a revenue source. Ancillary lab work beyond phlebotomy contributes but at much smaller scale, suggesting the center either performs basic in-office collection and sends most testing out or bills limited lab panels itself.

Competitive standing by code is mixed: 99213 ranks #9 of 41 providers in-state (80th percentile; typical, unremarkable volume for this code), indicating a solid but not dominant position for mid-level E/M visits. By contrast, 99212 ranks #2 of 16 (93rd percentile; typical, unremarkable volume), showing the center is a relatively strong provider of straightforward established-patient visits statewide, while 36415 ranks #9 of 15 (43th percentile; typical, unremarkable volume), which is a more modest placement for phlebotomy services.

Service complexity appears limited: higher-complexity outpatient E/M (99214) is low-volume (27 claims, $4.8K, ranks #39 of 43, 10th percentile) and visit-level services that do not require a physician present (99211) are also small contributors. This pattern supports an operational profile focused on routine, lower-acuity ambulatory care rather than specialty or high-intensity outpatient services.

Laboratory services beyond specimen collection generate only minor Medicaid revenue: the comprehensive metabolic panel 80053 accounts for $21K (2.2% of Medicaid revenue) and common tests such as 85025 (CBC) and 81003 (urinalysis dipstick) contribute $1.3K and $2K respectively. COVID-19 testing (87635) and a small volume of behavioral health psychotherapy (90834) are present but immaterial to overall revenue, reinforcing that labs and ancillary services are secondary to E/M and phlebotomy.

The provider’s NPI was enumerated on 2006-07-03 (~20 years ago), indicating an established market presence; combined with the concentrated Medicaid revenue profile, this suggests long-standing, stable operations geared toward routine ambulatory care for the Medicaid population. Analysts should weigh tenure as a positive indicator of continuity while still watching utilization shifts.

From a risk and strategy perspective, the center’s reliance on three codes for 94.4% of Medicaid revenue and on Medicaid exclusively creates sensitivity to state Medicaid rate changes, coding policy updates, or utilization shifts for office visits and venipuncture. Monitoring state-level reimbursement trends for 99213, 99212, and 36415 and peer movement in those codes will be important to assess near-term revenue vulnerability and opportunities to diversify services.

Medicaid: Complete Services Breakdown

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

16 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…	2,010	$160	$323.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,470	$220	$317.3K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,610	$150	$244.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	660	$30	$21K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	70	$110	$7.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	120	$50	$6K
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…	30	$180	$4.8K
87177	The lab analyst performs the technical steps to concentrate and evaluate specimens such as stool, to identify parasites and parasite eggs, also called ova, if present.	10	$310	$4K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	70	$40	$3.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	30	$80	$2.6K

Showing 1–10 of 16

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

Myrah Keating Smith Community Health Center — 0 of 14 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	9	20	1,920	$110	$858.9K
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	40	560	$140	$322K
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…	9	40	430	$110	$260.9K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	8	10	1,020	$110	$229.8K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	9	10	1,720	$40	$171.6K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	6	10	210	$40	$123K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	7	10	420	$80	$113.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	2	20	130	$110	$64.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	9	10	2,520	$20	$61.3K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	9	10	2,510	$20	$57.8K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emmanuel Graham	VI	Urology Physician	$318.4K	$0
Reva Richardson	VI	Internal Medicine Physician	$154.4K	$0
James Bennett	GA	Urology Physician	$112.2K	$0
David Weisher	VI	Medical Specialty Clinic/Center	$103.3K	$0
John Franklin	VI	Urology Physician	$92.3K	$0
Hillary Woodson Gaskins	VI	Family Medicine Physician	$62.6K	$0
Scott Hartshorn	VI	Family Medicine Physician	$56K	$0
Joseph Dejames	VI	Legal Medicine	$26.5K	$0
Tai Hunte	VI	Infectious Disease Physician	$15.9K	$8.7K
Elizabeth Barot	VI	Emergency Medicine Physician	$16.8K	$0

Myrah Keating Smith Community Health Center — Billing Profile & Reimbursement Data

Sign up for Myrah Keating Smith Community Health Center — Billing Profile & Reimbursement Data policy alerts

Myrah Keating Smith Community Health Center — Billing Profile & Reimbursement Data

Sign up for Myrah Keating Smith Community Health Center — Billing Profile & Reimbursement Data policy alerts

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