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NPI 1639118953 · St Thomas, VI · Surgery Physician
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Frank Odlum is a surgery physician provider located in St Thomas, U.S. Virgin Islands. This profile covers 5 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 | Frank Odlum |
| Address | 9149 Estate Thomas |
| City | St Thomas |
| State | VI |
| ZIP | 00802 |
| Taxonomy | Surgery Physician |
| NPI Enumerated | June 5, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $25.1K |
| Medicaid | $17.5K |
This provider bills modestly to both Medicare and Medicaid: total Medicare revenue on file is $25.1K while total Medicaid revenue is $17.5K, so Medicare is the larger payer but both programs represent relatively small absolute billing on the record. The overall scale suggests limited billing volume to public payers rather than absence of activity in either program.
Revenue is highly concentrated in a small set of services for both payers: the top 3 Medicare codes account for 78.1% of Medicare revenue, and the top 3 Medicaid codes account for 100.0% of Medicaid revenue. That concentration indicates that a few service lines drive nearly all program revenue rather than a broad mix of procedures.
Medicare billing is driven primarily by office/clinic evaluation-and-management codes and a pediatric surgical procedure: 99213 generated $9.1K (36.1% of Medicare revenue), 99204 generated $6K (24.0%), and 49505 generated $4.5K (18.0%). These codes point to a practice mix that includes ambulatory E/M visits as the largest component plus some surgical repair work consistent with a Surgery Physician taxonomy.
Medicare hospital-based E/M activity is also present: 99232 contributed $4.4K (17.4% of Medicare revenue) and 99222 contributed $1.1K (4.5%). The inclusion of 99232 and 99222 alongside office visit codes suggests the provider performs both inpatient follow-up and initial hospital evaluation in addition to outpatient clinic work.
Competitive standing for the provider’s top Medicare codes is modest rather than dominant: 99213 ranks #139263 of 457151 providers nationally (69th percentile; typical, unremarkable volume for this code) and 99204 ranks #61493 of 227068 providers nationally (72th percentile; typical, unremarkable volume for this code). The pediatric hernia repair code 49505 ranks #705 of 837 providers nationally (0th percentile; typical, unremarkable volume for this code), indicating participation in a small cohort of providers who bill that procedure but not at high volumes.
Medicaid activity is concentrated entirely in E/M office visits, with 99204 responsible for $10K (56.9% of Medicaid revenue) and 99213 responsible for $7.6K (43.1% of Medicaid revenue). In-state rank positions are modest: 99204 is #18 of 25 providers in-state (29th percentile; typical, unremarkable volume for this code) and 99213 is #29 of 41 providers in-state (30th percentile; typical, unremarkable volume for this code), so the provider is not a leading Medicaid biller statewide for these services.
The provider’s National Provider Identifier has been active since 2006-06-05 (~20 years ago), indicating long tenure in the registry. That longevity combined with a narrow set of billed services suggests an established practice pattern focused on office E/M and a limited set of surgical procedures.
Because Medicaid revenue is 100.0% concentrated in a small set of office visit codes (99204 and 99213) and Medicare revenue is 78.1% concentrated in its top three codes, the practice has limited diversification across service lines in public payers. For payers and network planners, this pattern signals a predictable, visit-focused footprint with some surgical capability but not broad procedural breadth across Medicare and Medicaid.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
5 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… | 140 | $60 | $9.1K |
| 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… | 60 | $100 | $6K |
| 49505 | The provider repairs an initial inguinal hernia on a child, five years of age or older. She pushes the hernia back to reduce it. | 10 | $410 | $4.5K |
| 99232 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 70 | $60 | $4.4K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 10 | $90 | $1.1K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 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 |
|---|---|---|---|---|
| 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 | $150 | $10K |
| 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… | 110 | $70 | $7.6K |
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 |
|---|---|---|---|---|---|---|
| 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… | 29 | 40 | 430 | $110 | $260.9K |
| 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… | 18 | 30 | 80 | $150 | $27K |
Other providers in the same ZIP code as Frank Odlum, ranked by combined Medicare and Medicaid revenue.
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