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.

Hercare Inc (NPI 1578997292)

Field	Value
Entity Type	Organization
Organization	Hercare Inc
Address	#1 Estate Cane Sunshine Mall
City	Frederiksted
State	VI
ZIP	00840
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	August 29, 2013

Payer Source	Total Paid
Medicaid	$182.9K
Medicare	$0

Key Findings

HERCARE INC is effectively a single-payer Medicaid provider in the claims data: there is no Medicare billing on file and all reported lifetime revenue is Medicaid-only at $182.9K, indicating its claims activity and revenue exposure are concentrated entirely within the Medicaid program. This single-payer profile suggests payer mix risk is concentrated in state Medicaid policies and reimbursement changes rather than Medicare market dynamics.

Revenue concentration is high: the top three Medicaid codes together account for 99.9% of the provider's total Medicaid revenue, indicating the practice’s income is almost entirely driven by a very small set of services rather than a broad mix of procedure codes. That degree of concentration makes the provider sensitive to utilization or reimbursement changes for those specific codes.

The practice’s principal revenue driver is office/outpatient E/M services: 99214 generates $110.4K (60.4% of Medicaid revenue) across 883 claims, reflecting a sustained focus on established patient office visits requiring moderate medical decision making or ~30+ minutes total time. This code ranking as #16 of 43 in-state (64th percentile) places HERCARE as a typical, not dominant, provider of this common ambulatory service relative to peers in the state.

The second major revenue component is code 99354 ($61.6K; 33.7% of Medicaid revenue across 463 claims), which typically represents prolonged services on an outpatient visit. 99354 ranks #3 of 4 in-state (33rd percentile), indicating that while prolonged services make up a material share of this provider’s Medicaid revenue, the provider is not among the high-volume statewide leaders for that code and the code is uncommon among peers.

99204 contributes $10.8K (5.9% of Medicaid revenue, 69 claims), consistent with occasional new-patient moderate-complexity visits; it ranks #17 of 25 in-state (33rd percentile), which again positions the provider as a modest-volume participant for new-patient E/M services rather than a major referral center that drives high new-patient volumes.

Ancillary testing is negligible: 87086 appears for 12 claims and $96 (0.1% of Medicaid revenue), indicating almost no reliance on quantitative urine culture billing in the overall revenue mix. Its presence at very low volume suggests ancillary laboratory work is not a meaningful revenue stream for this practice.

Competitive standing across the reported Medicaid codes is generally modest: the provider’s percentile ranks (64th for 99214, 33rd for 99354 and 99204) indicate typical to below-typical volumes relative to in-state peers rather than market leadership. There are a small number of providers in-state with higher volumes for these same codes, so HERCARE appears to operate as a smaller ambulatory OB/GYN practice within the local market.

Tenure in the NPI registry is long enough to establish stability: the NPI was enumerated on 2013-08-29 (~13 years ago), which supports that the provider has been active under this national identifier for over a decade and any billing patterns reflect an established practice rather than a newly opened operation.

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	880	$130	$110.4K
99354	N/A	460	$130	$61.6K
99204	The provider sees a new 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 provider…	70	$160	$10.8K
87086	Culture, bacterial; quantitative, colony count, urine.	10	$10	$100

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

Hercare Inc — 0 of 4 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

4 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…	16	40	560	$140	$322K
99354	N/A	3	10	730	$130	$92.6K
87086	Culture, bacterial; quantitative, colony count, urine.	3	10	10	$50	$74.3K
99204	The provider sees a new 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 provider…	17	30	80	$150	$27K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carmine Hendricks	VI	Family Medicine Physician	$25.3K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Frederiksted Health Care, Inc.	VI	Federally Qualified Health Center (FQHC)	$0	$24.3M
First Step Therapy	VI	Rehabilitation Hospital	$0	$757.8K
Rachel's Place	VI	Clinical Social Worker	$0	$222.1K
Kamaria Alexander	VI	Physician Assistant	$21.7K	$0
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

Hercare Inc — Billing Profile & Reimbursement Data

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Hercare 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