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.

Cog Restore, LLC (NPI 1194108761)

Key Findings

Field	Value
Entity Type	Organization
Organization	Cog Restore, LLC
Address	9053 Estate Thomas
City	St Thomas
State	VI
ZIP	00802
Taxonomy	Rehabilitation Clinic/Center
NPI Enumerated	July 1, 2015

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

COG RESTORE, LLC reports no Medicare billing on file and $2.1M in lifetime Medicaid revenue, indicating it operates effectively as a Medicaid-only biller in the available data set. This single-payer footprint should be treated as the primary commercial lens for contracting and utilization analysis since Medicare activity is absent.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 96.7% of this provider's total Medicaid revenue. That concentration signals that a small set of services drives nearly all Medicaid payments and that changes to reimbursement or utilization for those codes would have outsized impact on the provider’s revenue.

The provider’s code mix and volumes are consistent with an intensive outpatient rehabilitation operation: 97110 (therapeutic exercise) alone accounts for 32.9K claims and $1.8M revenue (87.9% of this provider's total Medicaid revenue), supplemented by manual therapy and PT evaluation codes such as 97140 and 97161. The dominance of high-volume, therapy-session codes suggests a throughput-oriented physical therapy model focused on repeated therapeutic exercise sessions and hands-on manual interventions.

Competitive standing varies by code: 97110 ranks #1 of 9 providers in-state and is at the 100th percentile, described as notably above typical state volume; this marks COG RESTORE as the clear statewide leader for that service. By contrast, 97140 is #2 of 6 (80th percentile; typical, unremarkable volume) and 97161 is #1 of 2 (100th percentile; typical, unremarkable volume), indicating leadership on select evaluation codes but otherwise normal-to-moderate relative volumes for other common PT services.

Several billed codes are reported with no meaningful peer-volume comparison in-state (notations of 0th percentile; no state peer volume comparison available), including 97035, 97162, 97116, 97016, and 97166. These entries imply solitary in-state reporting for those CPT/HCPCS lines in the dataset or gaps in peer reporting, which limits competitive benchmarking for those specific services.

There is a notable payment/reporting anomaly on 97010 where the provider shows 1.3K claims with $0 avg paid/claim and $0 revenue while still ranking #1 of 2 providers in-state (100th percentile; typical, unremarkable volume). This pattern should prompt payers to review whether 97010 is being submitted as a non-reimbursed/bundled item, subject to state-specific policy, or reflects a data capture quirk.

Tenure-wise, the provider’s NPI was enumerated on 2015-07-01 (~11 years ago), indicating several years of operation under the current billing entity; that history supports using multi-year trend checks if more longitudinal claims data are available. The established enrollment also strengthens the interpretability of current high-volume code patterns as sustained practice behavior rather than a short-lived spike.

From a payer management perspective, the extremely heavy reliance on 97110 (87.9% of Medicaid revenue) and the top-three concentration (96.7%) create clear levers for utilization-review or contract negotiation focus. Targeted audits or utilization-management strategies around high-volume therapeutic exercise sessions and associated evaluation codes would address the largest share of spend with minimal effort directed at numerous low-revenue codes.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	32,940	$60	$1.8M
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…	4,650	$30	$116.3K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	780	$80	$63.7K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	660	$40	$25.6K
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.	520	$40	$18.3K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	730	$10	$8.7K
G0283	Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care	550	$10	$6.1K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	70	$60	$4.1K
97116	The provider instructs the patient in the proper ways of practicing various exercises, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without…	170	$20	$2.6K
97016	In this procedure, the provider applies the vasopneumatic device to an extremity for the purpose of reducing edema, or swelling.	150	$20	$2.2K

Showing 1–10 of 12

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

Cog Restore, LLC — 2 of 11 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	1	10	2,030	$50	$281.5K
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.	4	10	520	$100	$237.1K
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…	2	10	740	$30	$52.7K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	3	10	660	$30	$36.4K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	1	10	400	$80	$32.3K
G0283	Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care	2	10	990	$10	$11.3K
97035	Physical therapists use different treatment modalities that can help strengthen, relax, and heal muscles from their strained conditions.	1	10	730	$10	$8.9K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	1	10	70	$60	$4.1K
97116	The provider instructs the patient in the proper ways of practicing various exercises, including climbing stairs, focusing on one or more areas, that assist them in walking comfortably and without…	1	10	170	$10	$2.5K
97016	In this procedure, the provider applies the vasopneumatic device to an extremity for the purpose of reducing edema, or swelling.	1	10	150	$10	$2.1K

Showing 1–10 of 12

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hunter Garrison	VI	Physical Therapist	$82.6K	$0
Cheryl Finn	VI	Physical Therapist	$41.4K	$0
Sheniah Campbell	VI	Occupational Therapist	$22.5K	$0
Kelsey Roberts	VI	Physical Rehabilitation Occupational Therapist	$22.4K	$0
Kniquiah Hughes	VI	Occupational Therapist	$18K	$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
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
Department Of Health	VI	Ambulatory Family Planning Facility	$0	$1.3M

Cog Restore, LLC — 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