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.

Lindsy Wagner LLC (NPI 1235402611)

Key Findings

Field	Value
Entity Type	Organization
Organization	Lindsy Wagner LLC
Address	5030 Anchor Way
City	Christiansted
State	VI
ZIP	00820
Taxonomy	Clinical Social Worker
NPI Enumerated	February 16, 2012

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

LINDSY WAGNER LLC is effectively a single-payer Medicaid practice at scale: there is no Medicare billing on file and the practice reports $2.2M in lifetime Medicaid revenue, so all measurable public-payer volume in the dataset is Medicaid-driven. The provider’s top three Medicaid codes account for 60.9% of total Medicaid revenue, indicating a concentrated revenue base within Medicaid.

The practice’s code mix shows a clear operational focus on adaptive behavior/ABA services and outpatient behavioral healthcare. High-volume, session-based ABA technician services (97153) and provider-directed ABA (97155) are the largest pieces of the revenue mix, and a substantial number of psychotherapy and E/M codes (90832/90834/90837 and 99214) appear alongside testing and evaluation codes (96130/96131/96139 and 90791/90792), consistent with a blended service model that delivers both ABA therapy and traditional behavioral health visits.

Revenue concentration is driven by a single dominant code: 97153 generates $796.8K (36.5% of Medicaid revenue) and is the largest revenue line, followed by 97155 at $288.8K (13.2%) and 99214 at $243.9K (11.2%); together these top three codes make up the precomputed 60.9% share of Medicaid revenue. That concentration suggests the practice’s financial performance is highly sensitive to utilization and reimbursement trends for ABA technician services and mid-level E/M visits.

Competitive standing for the ABA lines shows the provider reporting the highest in-state counts where peer data is limited: 97153 and 97155 both rank #1 of 1 providers in-state with the dataset noting no state peer volume comparison available for those codes. In other clinical areas the provider’s volumes are more comparable to peers—for example, 99214 ranks #10 of 43 providers in-state (79th percentile), characterized in the dataset as typical, unremarkable volume for that code.

Psychotherapy and psychiatric evaluation services are a significant secondary component of the practice portfolio. Codes 90833 (add-on psychotherapy with E/M), 90791 (psychiatric evaluation), 90834, 90832 and 90837 together contribute meaningful revenue (each listed between $101.3K and $124.7K for their respective codes) and several of these psychotherapy codes rank at or near the top of in-state reporting (many are listed as #1 of multiple providers or 100th percentile with the dataset’s characterization of typical, unremarkable volume). This pattern indicates concurrent delivery of psychotherapy and diagnostic services in addition to ABA.

The practice also reports a notable volume of standardized testing and test-adjunct services—96131 ($73.5K, 3.4%), 96130 ($39.2K, 1.8%), 96139 ($42.4K, 1.9%) and 96138 ($9.3K, 0.4%)—with several of those testing codes ranked #1 of limited in-state providers and labeled as having no state peer volume comparison available. These lines point to integrated assessment capacity supporting diagnostic and treatment planning work for the behavioral health and ABA services provided.

Operational intensity is evident in encounter-level detail: 97153 shows 2.2K claims with an average paid per claim of $363, and 97155 shows 1K claims at $279 avg paid/claim, reflecting a high-volume, time-based session billing pattern consistent with technician-delivered and provider-directed ABA treatment that is billed per 15-minute increment. The frequency and payment profile for these session codes imply a workflow built around many short, regular treatment encounters rather than a small number of high-dollar procedures.

The provider has an established presence in the dataset, with the NPI enumerated on 2012-02-16 (~14 years ago), which supports the interpretation that the billing pattern reflects an operational model matured over multiple years rather than a new entrant’s temporary spike in activity. Given the heavy Medicaid concentration and the dominance of a small group of codes, payers and network analysts should track reimbursement and authorization policies for ABA technician services and related psychotherapy/testing codes when assessing contract or utilization-management strategies for this provider.

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	2,200	$360	$796.8K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	1,040	$280	$288.8K
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…	2,240	$110	$243.9K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	1,920	$70	$124.7K
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.	1,510	$80	$116.3K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	740	$160	$115.8K
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…	1,300	$90	$115.5K
90832	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…	1,320	$80	$101.3K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	390	$190	$73.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	490	$130	$61.1K

Showing 1–10 of 21

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

Lindsy Wagner LLC — 6 of 21 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
97153	A technician, supervised by a physician or other qualified healthcare professional, administers adaptive behavior treatments that target conditions such as developmental disabilities associated with…	1	10	2,200	$360	$797K
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…	10	40	560	$140	$322K
97155	The provider, a physician or other qualified healthcare professional, administers adaptive behavior treatment face–to–face with one patient and makes modifications in the protocol targets and…	1	10	1,040	$280	$288.9K
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.	2	10	520	$100	$237.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	6	10	790	$180	$229K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	1	10	1,750	$80	$114.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	11	20	200	$150	$93.5K
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	1	10	390	$190	$73.7K
90832	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…	1	10	140	$90	$46.1K
96139	A technician administers two or more psychological or neuropsychological tests and scores them requiring an additional 30 minutes beyond the initial 30 minutes.	1	10	320	$130	$42.5K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sarah Cooper	VI	Physician Assistant	$22.9K	$0
Melinda Richards	VI	Professional Counselor	$0	$21.6K
Laura Hughes	SD	Clinical Psychologist	$18.4K	$0
Gloria Mendez	VI	Psychologist	$9.8K	$0
G Rita Dudley Grant	VI	Psychologist	$9.1K	$0
Mary Payne	WV	Neurology with Special Qualifications in Child Neurology Physician	$9K	$0
Sophia Parrilla	VI	Clinical Psychologist	$8.3K	$0

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
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
Island Dental Specialties Dba Toothworks	VI	Endodontics	$0	$1.5M

Lindsy Wagner 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