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.

Plessen Urgent Care, LLC (NPI 1518578541)

Key Findings

Field	Value
Entity Type	Organization
Organization	Plessen Urgent Care, LLC
Address	Sunny Isles Shopping Center
City	Christiansted
State	VI
ZIP	00820
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	August 13, 2020

Payer Source	Total Paid
Medicaid	$463.4K
Medicare	$0

This provider has no Medicare billing on file (Top Medicare section: "none below"), and all reported lifetime federal payer revenue comes from Medicaid, totaling $463.4K. In practice this makes PLESSEN URGENT CARE, LLC effectively a Medicaid-focused operation within the available claims dataset rather than a dual-payer practice.

Revenue is highly concentrated in a small set of Medicaid codes: the top three Medicaid codes (87811, 99213, 99211) together account for 79.5% of the provider's total Medicaid revenue. Individually, 87811 represents 32.6%, 99213 26.5%, and 99211 20.4% of Medicaid revenue, indicating reliance on a narrow set of services for the majority of billed dollars.

The code mix points to an urgent care model built around high-volume testing and low-acuity outpatient visits. 87811 (SARS–CoV–2 immunoassay) is the single largest revenue driver ($151K revenue, 4.2K claims, $36 avg paid/claim), while 99213 and 99211 together represent routine established-patient E/M encounters (99213: $122.8K revenue, 1.5K claims, $82 avg; 99211: $94.4K revenue, 4.3K claims, $22 avg), consistent with walk-in testing plus brief clinician encounters.

Competitive standing for the top testing code is notable within a small local peer set: 87811 ranks #1 of 3 providers in-state and is at the 100th percentile, but the accompanying label is "typical, unremarkable volume," so the rank reflects a small provider universe rather than a large-market dominance. In other words, PLESSEN URGENT CARE leads its tiny in-state cohort on this specific COVID immunoassay code without evidence of unusually high volume relative to broader norms.

For ambulatory E/M services the provider is an above-median participant in state comparisons: 99213 ranks #11 of 41 providers (75th percentile), indicating stronger-than-average billing for low-complexity established visits, and 99211 ranks #2 of 11 (90th percentile), showing particularly high relative volume for very low-acuity visits that may involve no physician presence. By contrast, higher-complexity E/M code 99214 sits at the 33rd percentile (29 of 43), signaling a more limited role for moderate-complexity outpatient care.

Other service lines are present but limited in economic impact. 87635 (NAAT for SARS–CoV–2) contributes $40.1K (1K claims, $39 avg paid/claim) and ranks #4 of 8 in-state (57th percentile), while imaging and panel testing codes such as 71046, 80053 and 85025 appear at very low volumes and occupy 0th-percentile positions in-state—e.g., 71046 has 14 claims and $434 revenue—indicating minimal chest x-ray or broad lab-panel billing relative to peers.

Operational footprint is consistent with a relatively recent, small urgent care: the NPI was enumerated 2020-08-13 (~6 years ago) and lifetime Medicaid revenue is $463.4K. High claim counts on low-unit-payment services (87811: 4.2K claims; 99211: 4.3K claims) suggest throughput of many brief encounters and point-of-care tests rather than a focus on higher-reimbursement, lower-volume procedures.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	4,200	$40	$151K
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…	1,500	$80	$122.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	4,290	$20	$94.4K
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…	1,030	$40	$40.1K
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…	330	$110	$35.2K
99203	The provider sees a new 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 provider…	180	$100	$17.6K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	170	$10	$1.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	10	$30	$430
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	10	$20	$240
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.	20	$10	$120

Showing 1–10 of 12

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

Plessen Urgent Care, LLC — 1 of 12 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

12 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…	29	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…	11	40	430	$110	$260.9K
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…	4	10	1,020	$110	$229.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	5	10	3,310	$60	$177.3K
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.	12	10	1,720	$40	$171.6K
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…	8	10	210	$40	$123K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	1	10	4,120	$40	$121.6K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	2	10	470	$40	$51.6K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	13	10	2,510	$10	$45.4K
99203	The provider sees a new 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 provider…	8	20	80	$90	$27K

Showing 1–10 of 12

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

Plessen Urgent Care, LLC — Billing Profile & Reimbursement Data

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Plessen Urgent Care, 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

Nearby Providers

Frequently Asked Questions

References