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.

Pediatric Care Center LLC (NPI 1619186087)

Key Findings

Field	Value
Entity Type	Organization
Organization	Pediatric Care Center LLC
Address	4504 Estate Diamond Ruby
City	Christiansted
State	VI
ZIP	00820
Taxonomy	Pediatrics Physician
NPI Enumerated	May 22, 2007

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

PEDIATRIC CARE CENTER LLC appears to operate effectively as a Medicaid-focused pediatric practice: Total Medicare revenue is none (no Medicare billing on file) while lifetime Medicaid revenue is $1.7M, so the provider is effectively single-payer in this dataset. The NPI was enumerated on 2007-05-22 (~19 years ago), indicating an established local presence rather than a recent entrant.

Revenue is highly concentrated in three codes: 99213 ($654.4K, 39.0%), 99391 ($247K, 14.7%), and 99392 ($184.8K, 11.0%), which together account for 64.7% of this provider's total Medicaid revenue. This concentration indicates that a relatively small set of E/M and preventive visit codes drive the majority of billing and collections for this entity.

The code mix points to a primary-care pediatric practice with a strong emphasis on routine office management and preventive services: 99213 (7.7K claims, $85 avg paid/claim, $654.4K revenue) is the single largest revenue driver, and preventive medicine codes 99391 (2.1K claims, $115 avg paid/claim, $247K) and 99392 (1.7K claims, $112 avg paid/claim, $184.8K) are also top contributors. High-volume vaccine administration codes 90460 (3.3K claims, $39 avg paid/claim, $130.5K) and 90461 (2.2K claims, $51 avg paid/claim, $110.4K) further support that immunizations and well-child care are central to the practice.

For preventive and screening services this provider is often a market leader in-state: 99391 ranks #1 of 4 providers (100th percentile), 96110 ranks #1 of 2 providers (100th percentile) with 3.9K claims and $86K revenue, and 99177 ranks #1 of 2 providers (100th percentile) with 4.4K claims and $57.6K revenue. These ranks indicate the practice delivers a high volume of developmental, vision, and early preventive services compared with the small set of in-state peers tracked for those codes.

Although 99213 places the practice among higher-volume peers (#3 of 41, 95th percentile) the dataset labels its volume for that code as "typical, unremarkable volume," suggesting that high rank emerges from a small statewide peer group rather than from unusual intensity of service mix. By contrast, moderate-complexity visits billed as 99214 account for 698 claims and $83.1K (4.9%) and rank #17 of 43 (62th percentile), which together imply the practice’s visit profile skews toward lower-complexity established-patient visits rather than a higher share of complex office evaluations.

Several vaccine product codes show substantial claim counts but report $0 avg paid/claim and $0 revenue (for example, 90670: 1K claims $0 avg paid/claim $0 revenue, 90647: 323 claims $0 avg paid/claim $0 revenue, 90677: 193 claims $0 avg paid/claim $0 revenue). This pattern is visible across multiple product codes and may reflect billing or reimbursement routing where product costs are captured differently from administration fees; the dataset documents the activity but no paid amounts for those product codes.

Operationally, the practice’s service portfolio is broad within pediatric primary care: alongside well-child and E/M visits it bills substantial volumes for developmental screening (96110: 3.9K claims, $22 avg paid/claim, $86K revenue) and hearing screens (92551: 1.5K claims, $26 avg paid/claim, $39.4K revenue), both of which rank #1 in-state for their small peer groups (100th percentiles). These data suggest a workflow that integrates routine screening and preventive workflows into ambulatory visits, which could support care-management or quality initiatives focused on early childhood development and immunization completion.

Overall competitive standing is that of an established, locally prominent pediatric Medicaid provider rather than a large regional system player: the practice ranks in top positions for several preventive and screening codes within the very small in-state peer sets (multiple 100th-percentile ranks), but its total Medicaid lifetime revenue of $1.7M and absence of any Medicare billing indicate modest absolute scale and a narrow payer footprint concentrated on pediatric Medicaid services.

Medicaid: Complete Services Breakdown

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

28 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…	7,700	$90	$654.4K
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…	2,150	$120	$247K
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…	1,650	$110	$184.8K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	3,350	$40	$130.5K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	2,170	$50	$110.4K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	3,910	$20	$86K
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…	700	$120	$83.1K
99177	The provider uses instruments to conduct a vision screening exam to analyze both eyes to diagnose ocular or eye–related diseases. Both the screening and analysis take place on–site.	4,430	$10	$57.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	490	$110	$51.7K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	1,520	$30	$39.4K

Showing 1–10 of 28

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

Pediatric Care Center LLC — 4 of 16 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

28 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…	17	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…	3	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…	1	10	2,030	$150	$248.7K
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…	3	10	1,540	$150	$221.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	3	10	960	$160	$154.2K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	3	10	5,290	$20	$108.2K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	3	10	3,160	$30	$96.4K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	1	10	2,050	$20	$44.3K
99177	The provider uses instruments to conduct a vision screening exam to analyze both eyes to diagnose ocular or eye–related diseases. Both the screening and analysis take place on–site.	1	10	2,240	$10	$29.9K
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…	17	20	80	$90	$27K

Showing 1–10 of 28

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

Pediatric Care Center 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