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NPI 1437197613 · Christiansted, VI · Anesthesiology Physician
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Carlos Sanchez is a anesthesiology physician provider located in Christiansted, U.S. Virgin Islands. This profile covers 6 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Carlos Sanchez |
| Address | 4007 Estate Diamond Ruby |
| City | Christiansted |
| State | VI |
| ZIP | 00820 |
| Taxonomy | Anesthesiology Physician |
| NPI Enumerated | June 2, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $24.4K |
| Medicaid | $2.2K |
Provider is effectively Medicare-dominant: lifetime Medicare revenue is $24.4K compared with total Medicaid revenue of $2.2K, indicating Medicare drives the majority of reimbursed activity while Medicaid is a much smaller revenue source for this provider. The presence of both payers shows some mixed coverage but a heavy skew toward Medicare volume and dollars.
Medicare revenue is highly concentrated in a few anesthesia procedures: the top three Medicare codes (00142, 01916, 01844) account for 78.8% of this provider's Medicare revenue. Those codes individually represent $12.2K (00142), $4.4K (01916), and $2.7K (01844) of the $24.4K total, signaling a narrow set of services driving most Medicare income.
Service-line implications from code mix point to focused anesthesia practice across ophthalmic, endovascular, and vascular-access procedures: 00142 is anesthesia for an eye lens procedure, 01916 covers anesthesia for diagnostic arteriography/venography, and 01844 applies to anesthesia for vascular shunt procedures (e.g., for dialysis). This combination suggests the provider commonly staffs short, procedure-specific anesthesia cases across ophthalmology, interventional radiology/vascular imaging, and dialysis-access surgery rather than broad-spectrum inpatient anesthesia.
Competitive standing for the largest Medicare code (00142) is modest nationally: 00142 accounts for $12.2K (49.9% of Medicare revenue) and ranks #3590 of 19760 providers nationally (82th percentile) with a plain-English characterization of "typical, unremarkable volume." In practical terms, 00142 is the single largest revenue driver here but the provider is not a dominant national player for that service despite it being the primary revenue source.
01916 shows comparatively stronger market positioning: the code generates $4.4K (18.0% of Medicare revenue) and ranks #53 of 383 providers nationally (86th percentile) with a label of "typical, unremarkable volume." This rank implies above-average activity for anesthesia associated with diagnostic arteriography/venography relative to national peers, indicating a relative specialty or repeat engagement in vascular imaging cases.
Other Medicare codes are lower-volume or mixed in standing: 01844 contributes $2.7K (10.9% of Medicare revenue) and ranks #568 of 1023 (37th percentile), while codes such as 01938 and 00635 appear with small revenue shares and are characterized as "typical, unremarkable volume." These lower percentiles and smaller dollar contributions suggest the provider’s Medicare footprint is concentrated in a few procedure types with limited breadth across other anesthesia service lines.
Medicaid billing is narrowly concentrated and atypical in composition: the top Medicaid code 99140 accounts for 100.0% of Medicaid revenue ($2.1K) across 58 claims and is recorded as #1 of 1 providers in-state (0th percentile) with no state peer volume comparison available, indicating Medicaid activity is confined to emergency/add-on anesthesia circumstances rather than routine primary anesthesia procedures. The presence of 99072 (30 claims, $0 revenue) further underscores that Medicaid billing here is limited and focused on specific add-ons or encounter-related items rather than a broad Medicaid anesthesia practice.
Provider tenure is long-standing: NPI was enumerated on 2006-06-02 (~20 years ago), indicating two decades of formal enrollment. Despite that tenure, the absolute lifetime Medicare and Medicaid revenue totals ($24.4K and $2.2K) are modest, which may reflect a low-volume practice, part-time clinical engagement, or a practice that predominantly bills to non-Medicare/Medicaid payers not visible in this dataset.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
6 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 110 | $110 | $12.2K |
| 01916 | The provider performs anesthesia services for a patient undergoing diagnostic arteriography or venography. | 30 | $150 | $4.4K |
| 01844 | The provider performs anesthesia services for a patient undergoing a vascular shunt procedure, or shunt revision of any type, such as for dialysis. | 10 | $190 | $2.7K |
| 01938 | The provider performs anesthesia services for a patient undergoing percutaneous image–guided injection, drainage, or aspiration procedures on the lumbar or sacral spine or spinal cord. | 20 | $110 | $1.8K |
| 00635 | The provider performs anesthesia services for a patient undergoing a procedure in the lumbar region, including a diagnostic or therapeutic lumbar puncture. | 20 | $110 | $1.7K |
| 00400 | The provider performs anesthesia services for a patient undergoing any procedure on the integumentary system on the extremities, anterior trunk and perineum, not otherwise specified. | 10 | $140 | $1.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 99140 | This code, describing emergency conditions, is a qualifying circumstance CPT code. This add–on code, used along with a primary anesthesia procedure code, is applied only in cases when application of… | 60 | $40 | $2.1K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. U.S. Virgin Islands median
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99140 | This code, describing emergency conditions, is a qualifying circumstance CPT code. This add–on code, used along with a primary anesthesia procedure code, is applied only in cases when application of… | 1 | 10 | 60 | $40 | $2.2K |
| 99072 | The provider uses items, supplies materials, or requires clinical staff time in excess of what is normally used or provided for an office visit or other nonfacility encounter. These additional items… | 4 | 10 | 70 | $0 | $0 |
Other providers in the same ZIP code as Carlos Sanchez, ranked by combined Medicare and Medicaid revenue.
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