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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Virginia 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. Virginia (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.

Fishing Point Health Care LLC (NPI 1679279046)

Key Findings

Field	Value
Entity Type	Organization
Organization	Fishing Point Health Care LLC
Address	2929 London Blvd
City	Portsmouth
State	VA
ZIP	23707
Taxonomy	General Practice Physician
NPI Enumerated	February 6, 2023

Payer Source	Total Paid
Medicaid	$169.8M
Medicare	$0

This entity is effectively a Medicaid-only biller: there is no Medicare billing on file and lifetime Medicaid revenue totals $169.8M. That payer concentration means the provider’s financial footprint and payer negotiations will be governed almost entirely by state Medicaid policy and reimbursement levels rather than by Medicare dynamics.

Revenue is extremely concentrated in a small set of codes: the top 3 Medicaid codes account for 97.9% of the provider’s total Medicaid revenue, led by S5121 at $152.7M (89.9% of Medicaid revenue), followed by Q5009 at $12.4M (7.3%) and 90853 at $1.2M (0.7%). This concentration indicates that a single service line drives almost the entire revenue base.

The dominant code mix points to a home- and community-based services model: S5121 (Chore services; per diem) and Q5009 (Hospice or home health care provided in place nos) together represent the vast majority of billed dollars, while 90853 (group psychotherapy) signals an ancillary behavioral-health offering. Operationally, this combination is consistent with an organization delivering per-diem personal care/chore services and some home health/hospice and group behavioral services rather than a typical office-based primary care practice.

State-level competitive standing for the core chore-service line is prominent by rank: S5121 ranks #1 of 3 providers in-state and is at the 100th percentile for this code. Note that the dataset’s descriptor for S5121 is “typical, unremarkable volume for this code,” so while this provider is the largest in-state by revenue on S5121, the competitive set for this specific service is small.

For the second and third codes the provider is a more modest participant: Q5009 ranks #2 of 2 providers in-state (0th percentile) and is described as “typical, unremarkable volume for this code,” indicating limited statewide competition on that code; 90853 ranks #73 of 170 providers in-state (57th percentile) and is likewise labeled “typical, unremarkable volume for this code,” which positions the provider as a mid‑table participant in group psychotherapy services.

The broader code mix includes routine E/M, lab, therapy, and procedural codes but each contributes only a small share of revenue: for example, 99213 (572 claims, $411.3K revenue), 97110 (93 claims, $180.5K revenue) and 80061 (208 claims, $149.6K revenue) appear on the roster but are minor relative to the S5121-driven top line. This pattern suggests administrative and clinical capacity for ancillary outpatient services, yet these lines are not major revenue drivers.

From a contracting and risk perspective, the provider’s reliance on one dominant per-diem code creates sensitivity to changes in Medicaid rates, prior‑authorization rules, and state program design for personal care/chore services. Payers evaluating network adequacy or capitation arrangements should treat this provider as high-impact for Medicaid chore services but limited diversification exists across other Medicaid service categories.

The provider’s NPI was enumerated 2023-02-06 (~3 years ago), and the current billing mix — $169.8M in Medicaid revenue concentrated primarily in S5121 — is consistent with a relatively recent market entry that has scaled quickly into the state’s chore/home‑health space. Analysts should treat the recency of enrollment together with high revenue concentration as a flag to review enrollment history, contracting timelines, and any state program changes that may have enabled rapid scale-up.

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5121	Chore services; per diem	117,150	$1,300	$152.7M
Q5009	Hospice or home health care provided in place not otherwise specified (nos)	15,870	$780	$12.4M
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	1,520	$760	$1.2M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	1,110	$730	$807.7K
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…	570	$720	$411.3K
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…	440	$720	$312.8K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	420	$720	$303.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	90	$1,940	$180.5K
85027	The lab analyst performs a blood count on the red and white blood cells and platelets also known as thrombocytes. He also determines the hemoglobin, typically by spectrophotometry, and the…	220	$720	$159.6K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	210	$720	$149.6K

Showing 1–10 of 29

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Fishing Point Health Care LLC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5121	Chore services; per diem	1	10	33,870	$1,330	$66.9M
Q5009	Hospice or home health care provided in place not otherwise specified (nos)	2	10	22,960	$800	$18.4M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	134	170	3,790	$40	$415.2K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	358	400	1,910	$50	$412.6K
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…	1,673	3,520	370	$70	$280.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	543	1,340	710	$90	$245K
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…	1,581	4,010	290	$50	$199.8K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	194	330	270	$40	$112.2K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	99	120	450	$100	$110.2K
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.	178	230	5,240	$1	$93.2K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maryview Hospital LLC	VA	General Acute Care Hospital	$0	$74.9M
Safe Harbor Behavioral Healthcare, LLC	VA	Substance Abuse Rehabilitation Facility	$0	$13.8M
Premier Home Health Care LLC	VA	Home Health Agency	$0	$9.4M
Connecting Communities, LLC	VA	Community/Behavioral Health Agency	$0	$9.2M
Anointed And Blessed Home Health Care, LLC	VA	Home Health Agency	$0	$7.4M
Patient Centered Care	VA	Home Health Agency	$0	$6.3M
Gloria's Angels Home Health Care	VA	Home Health Agency	$0	$6.1M
Tidewater Medical Transport, Inc	VA	Ambulance	$394.5K	$171.2K
Karen Olmo	VA	Physician Assistant	$251.2K	$0
Steven Blasdell	VA	Orthopaedic Surgery Physician	$171.8K	$1.2K

Fishing Point Health 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