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.

Graham Urological Center LLC (NPI 1205149879)

Field	Value
Entity Type	Organization
Organization	Graham Urological Center LLC
Address	6300 Estate Peters Rst Ste 1
City	Christiansted
State	VI
ZIP	00820
Taxonomy	Clinic/Center
NPI Enumerated	July 23, 2010

Payer Source	Total Paid
Medicaid	$377.5K
Medicare	$0

Key Findings

This provider is effectively a single-payer Medicaid operation: there is no Medicare billing on file and all recorded lifetime fee-for-service revenue is $377.5K in Medicaid. The absence of Medicare activity means the practice’s payment mix and financial exposure are concentrated entirely in the Medicaid program.

GRAHAM UROLOGICAL CENTER LLC has an established presence in the dataset, with an NPI enumerated on 2010-07-23 (~16 years ago), indicating more than a decade of operational tenure in CHRISTIANSTED, VI. That tenure supports the interpretation that the observed billing profile reflects a stable local practice rather than a short-lived billing anomaly.

Revenue is heavily concentrated in three evaluation-and-management codes: 99214 ($160.3K, 42.5%), 99213 ($116.8K, 30.9%), and 99204 ($69.7K, 18.5%) — together these top 3 Medicaid codes account for 91.9% of this provider’s total Medicaid revenue. This concentration shows that outpatient office visits (established and new patients) are by far the core revenue drivers for the clinic.

The detailed code mix aligns with an outpatient urology clinic model: high-volume E&M activity (99214: 2K claims, $79 avg paid/claim; 99213: 2.2K claims, $53 avg paid/claim; 99204: 491 claims, $142 avg paid/claim) supplemented by procedure-level urology services such as catheterization 51703 (304 claims, $21.6K revenue), bladder residual ultrasound 51798 (1.2K claims, $8.2K revenue), and uroflow 51741 (69 claims, $690 revenue). Ancillary lab work appears limited (81003: 263 claims, $263 revenue), reinforcing that the practice is visit-driven rather than lab-driven.

Competitive standing is mixed across top codes: 99204 ranks #2 of 25 providers in-state (96th percentile), indicating the provider is a strong performer among peers for new-patient moderate-complexity visits, while 99213 (rank #8 of 41, 83th percentile) and 99214 (rank #12 of 43, 74th percentile) are described as typical, unremarkable volumes in-state. In short, the clinic is a notable outlier for new patient complexity but a more modest participant for routine established-patient visits.

Several urology-specific procedure codes are recorded with no state peer comparison in the dataset: 51703, 51798, and 51741 each rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available). This pattern suggests the clinic is the sole Medicaid reporter for these procedures in the available data, which could reflect either a unique local service offering or gaps in peer reporting.

The claim-level economics show different reimbursement profiles across the top codes: 99204 has a higher average paid/claim ($142) compared with 99214 ($79) and 99213 ($53), which explains why fewer 99204 claims (491) still generate meaningful revenue ($69.7K). These per-claim differences, combined with heavy volume in lower-paid established-patient codes, shape the practice’s revenue sensitivity to changes in visit mix or reimbursement rates.

Operational and financial risk is concentrated: with 91.9% of Medicaid revenue coming from three E&M codes and no Medicare revenue to diversify payer mix, the provider’s financial performance will be highly sensitive to changes in Medicaid E&M reimbursement policies, referral patterns, or local demand for urologic office visits. Monitoring shifts in volume for 99214, 99213, and 99204 should be prioritized for any payer/provider analysis of this entity.

Medicaid: Complete Services Breakdown

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

7 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…	2,030	$80	$160.3K
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…	2,200	$50	$116.8K
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…	490	$140	$69.7K
51703	The bladder catheter CPT codes provide options for reporting the procedures that best reflect the exact anatomic location of a catheter insertion, the type of catheter inserted, and, in some cases,…	300	$70	$21.6K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	1,170	$10	$8.2K
51741	Uroflowmetry (UFR) is the process of measuring how much liquid the patient excretes from the bladder. It is measured in cubic centimeters per second. The rate is the ratio of volume over time.	70	$10	$690
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…	260	$1	$260

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

Graham Urological Center LLC — 1 of 7 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

7 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…	12	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…	8	40	430	$110	$260.9K
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…	5	10	210	$40	$123K
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…	2	30	80	$150	$27K
51703	The bladder catheter CPT codes provide options for reporting the procedures that best reflect the exact anatomic location of a catheter insertion, the type of catheter inserted, and, in some cases,…	1	10	300	$70	$21.5K
51798	Providers perform this ultrasound to measure the volume of residual urine in the bladder.	1	10	1,170	$10	$8.6K
51741	Uroflowmetry (UFR) is the process of measuring how much liquid the patient excretes from the bladder. It is measured in cubic centimeters per second. The rate is the ratio of volume over time.	1	10	70	$10	$670

Related Providers

Other providers that share a Tax Identification Number (TIN) with Graham Urological Center LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emmanuel Graham	VI	Urology Physician	$318.4K	$0

Nearby Providers

Other providers in the same ZIP code as Graham Urological Center LLC, 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

Graham Urological Center LLC — Billing Profile & Reimbursement Data

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Graham Urological Center 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