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.

Frederiksted Health Care, Inc. (NPI 1437215134)

Field	Value
Entity Type	Organization
Organization	Frederiksted Health Care, Inc.
Address	516 Strand St
City	Frederiksted
State	VI
ZIP	00840
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	December 28, 2006

Payer Source	Total Paid
Medicaid	$24.3M
Medicare	$0

Key Findings

FREDERIKSTED HEALTH CARE, INC. is effectively a Medicaid-centric Federally Qualified Health Center: there is no Medicare billing on file while total Medicaid revenue is $24.3M, indicating the organization's financial scale and payer concentration are driven almost entirely by Medicaid. The absence of Medicare activity makes this provider functionally single-payer (Medicaid) for the claims data available.

Revenue concentration is high: the top three Medicaid codes by revenue account for 58.0% of the provider's total Medicaid revenue, signaling that a small set of services—primarily office E/M visits and key lab work—drive the majority of payments. This concentration suggests that changes in reimbursement or utilization for those codes would materially affect the provider's overall revenue.

The two highest-revenue Medicaid codes are 99213 ($5.4M, 27.0% of Medicaid revenue) and 99214 ($4.9M, 24.7% of Medicaid revenue), reflecting a service mix dominated by established patient evaluation-and-management visits at low-to-moderate complexity. Together these visit codes imply the facility operates as a high-volume primary care outpatient practice, delivering routine chronic care and longitudinal management rather than specialty procedural services.

FREDERIKSTED is a statewide volume leader on multiple core codes: it ranks #1 in-state for 99213 and 99214 (both at the 100th percentile and described as extreme outlier, far above typical state volume), and also ranks #1 for a range of lab and specimen codes such as 99000, 87635, 87491, 87591, 87086, 81025, and 82962 (many at the 100th percentile). These rankings indicate dominant local share for primary care encounters and common in-office diagnostic testing, reinforcing its role as a primary access point for Medicaid members in the state.

Laboratory services and point-of-care testing form a meaningful secondary revenue stream: 80053 (CMP) contributes $1.2M (6.2% of Medicaid revenue) and other lab codes (87635, 87491, 87591, 80061, 84443, 85025, 87086, 82962) cumulatively represent significant volumes and rankings, often at or near the top statewide. The prevalence and high claim counts for specimen processing codes like 99000 (29.4K claims) and blood draw 36415 (26.3K claims) suggest the center operates in-house specimen collection and sends high volumes to testing—consistent with an integrated FQHC clinical-lab workflow.

The provider shows strong dental and preventive care activity alongside medical services: multiple dental codes (D1330, D0150, D0330, D0140, D2392, D7140, D2391) and pediatric preventive codes (99391, 99392, 99393) appear in the top Medicaid code list with meaningful revenue shares. This mix reflects the broad primary-care mandate of an FQHC offering medical, dental, and preventive services to the Medicaid population rather than focusing on a narrow clinical specialty.

Tenure is long enough to indicate established operations: the NPI was enumerated on 2006-12-28 (~20 years ago), which supports a stable presence in the local market and aligns with its dominant statewide rankings on core primary-care and lab codes. Longevity combined with the high-volume code mix suggests entrenched referral and patient-acquisition patterns in the community.

Several codes are flagged as statistical outliers or notably above typical state volume, which is operationally informative without implying impropriety: 99213 and 99214 are labeled extreme outlier and far above typical state volume, while codes such as 87635, 87491, 87591, and 36415 are described as notably above typical state volume. For payers and analysts, these signals identify where utilization and unit-volume audits, benchmarking, or contract negotiations would be most relevant—namely office E/M and high-volume lab/testing services.

Medicaid: Complete Services Breakdown

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

176 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	38,310	$140	$5.4M
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…	26,850	$180	$4.9M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	7,500	$170	$1.2M
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	29,430	$30	$824K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	7,230	$100	$729.8K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	7,170	$90	$609.3K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	7,010	$90	$595.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	26,270	$20	$499.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,930	$160	$474.7K
D1330	N/A	6,680	$60	$413.9K

Showing 1–10 of 176

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

Frederiksted Health Care, Inc. — 12 of 25 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

176 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	3	20	1,920	$110	$858.9K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	1	10	14,730	$30	$417.2K
D2392	Post 2 surface resin‑based composite	3	10	520	$230	$376.2K
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…	1	40	560	$140	$322K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	4	10	1,120	$160	$299.5K
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…	1	40	430	$110	$260.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	3	10	2,030	$150	$248.7K
D4341	Periodontal scaling and root planing - four or more teeth per quadrant	2	10	920	$250	$247.5K
D2391	Resin‑based composite – one surface, posterior	2	10	190	$180	$232.4K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	1	10	1,020	$110	$229.8K

Showing 1–10 of 176

Related Providers

Other providers that share a Tax Identification Number (TIN) with Frederiksted Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Renee Georges	VI	Surgery Physician	$25.4K	$100.5K
Michelle Dizon	VI	Endocrinology, Diabetes & Metabolism Physician	$92.2K	$0
Carolyn Merritt	VI	Procedural Dermatology Physician	$43.7K	$27.3K
Ria Lutchmeesingh	VI	Optometrist	$53K	$0
Gemaine Owen	VI	Family Medicine Physician	$22.1K	$23.2K
Josephine Kozloff	VI	Physician Assistant	$30.3K	$0
Larissa Leffingwell	VI	Medical Physician Assistant	$27.2K	$0
Carmine Hendricks	VI	Family Medicine Physician	$25.3K	$0
Sarah Cooper	VI	Physician Assistant	$22.9K	$0
Kamaria Alexander	VI	Physician Assistant	$21.7K	$0

Nearby Providers

Other providers in the same ZIP code as Frederiksted Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
First Step Therapy	VI	Rehabilitation Hospital	$0	$757.8K
Rachel's Place	VI	Clinical Social Worker	$0	$222.1K
Hercare Inc	VI	Obstetrics & Gynecology Physician	$0	$182.9K
Luis Frias Mendoza	VI	Neurology Physician	$19K	$1.7K
Jozette Matthews	VI	Family Nurse Practitioner	$13.9K	$0
Shavell Karel	VI	Obstetrics & Gynecology Physician	$4.1K	$0
Shelley Timmons	VI	Physical Therapist	$2.1K	$0
Neighborhood Pharmacy LLC	VI	Community/Retail Pharmacy	$1.6K	$0

Frederiksted Health Care, Inc. — Billing Profile & Reimbursement Data

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Frederiksted Health Care, Inc. — 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