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.

Walter Gardiner (NPI 1225035280)

Field	Value
Entity Type	Individual
Organization	Walter Gardiner
Address	5134 Sundial Park
City	Christiansted
State	VI
ZIP	00820
Taxonomy	Ph.D. Medical Genetics
NPI Enumerated	July 6, 2005

Payer Source	Total Paid
Medicare	$120.5K
Medicaid	$0

Key Findings

WALTER GARDINER's Medicare activity is tightly concentrated in dialysis-related monthly management codes: 90960 and 90961 together account for 94.6% of the provider's Medicare revenue, and the precomputed note that the top three Medicare codes represent 97.2% of total Medicare revenue underscores that nearly all Medicare dollars come from a small set of services. This concentration indicates the provider operates primarily in ESRD monthly care management rather than a broad outpatient practice mix.

Code-level volume shows a specialized service-line focus: 90960 alone represents $96K of the $120.5K total Medicare revenue (79.6% of the provider's Medicare revenue) from 400 claims, and 90961 contributes $18K (15.0%) from 96 claims; the remaining billed evaluation-and-management codes (99214, 99213) and remote monitoring (99457) are comparatively minor revenue sources. Together these figures support an operational model centered on recurring monthly ESRD management encounters rather than episodic office visits.

Competitive standing on Medicare for the top dialysis management code is elevated: the provider ranks #426 of 6549 providers nationally for 90960 and is described as "notably above typical national volume for this code," indicating a significantly higher-than-typical market share for that specific ESRD service relative to peers. For 90961 the provider ranks #1102 of 6091 (82nd percentile), which the data labels as "typical, unremarkable volume," so while 90961 is a meaningful revenue contributor it is less distinctive competitively than 90960.

This entity is effectively single-payer in the available data: lifetime Medicare revenue is $120.5K while there is no Medicaid billing on file. The absence of Medicaid claims means payer mix is concentrated entirely on Medicare in the datasets provided, which has implications for contracting, reimbursement risk, and market reach in the territory.

Tenure is long-lived: the provider's NPI was enumerated on 2005-07-06 (approximately 21 years ago), which suggests an established presence in the market and that the observed billing pattern represents an enduring service footprint rather than a recently launched specialty. This duration supports interpreting the concentrated ESRD billing as a stable practice focus.

Lower-level E/M and remote monitoring activity is present but small: 99214 ($3.2K, 40 claims) and 99213 ($2.2K, 42 claims) together represent only a few percent of Medicare revenue, and 99457 contributes approximately $1.2K. These volumes and ranking percentiles (23rd–32nd for the E/M codes, 9th percentile for 99457) suggest routine, ancillary outpatient and RPM services that supplement the core ESRD management business rather than driving the practice.

Revenue concentration creates operational sensitivity to ESRD policy and reimbursement changes: because 90960 and 90961 drive the majority of Medicare dollars (with the top three codes accounting for 97.2% of Medicare revenue), any shifts in ESRD monthly management payment or utilization would disproportionately affect this provider's Medicare revenue stream. Analysts and payers should treat this as a targeted clinical line of business when evaluating network value or rate negotiations.

Medicare: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	400	$240	$96K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	100	$190	$18K
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…	40	$80	$3.2K
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…	40	$50	$2.2K
99457	The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month and…	30	$40	$1.2K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. U.S. Virgin Islands Distribution

Walter Gardiner — 2 of 5 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

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	1	10	270	$250	$72.4K
99214	54	80	100	$80	$15.5K
90961	1	10	60	$190	$10.7K
99213	61	80	100	$50	$7.6K
99457	4	10	150	$40	$5.8K

Nearby Providers

Other providers in the same ZIP code as Walter Gardiner, 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

Walter Gardiner — 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