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.

St Croix Gastroenterology Center LLC (NPI 1992983902)

Field	Value
Entity Type	Organization
Organization	St Croix Gastroenterology Center LLC
Address	61 Herman Hill
City	St Croix
State	VI
ZIP	00820
Taxonomy	Specialist
NPI Enumerated	February 1, 2008

Payer Source	Total Paid
Medicaid	$114.5K
Medicare	$0

Key Findings

This provider has no Medicare billing on file (Medicare revenue: none) and reports $114.5K in lifetime Medicaid revenue, making its public payer footprint effectively single-payer Medicaid. The NPI was enumerated on 2008-02-01 (~18 years ago), indicating long-standing enrollment despite modest reported Medicaid volume.

Revenue is highly concentrated: the top three Medicaid codes (43239, 99203, 99204) together account for 67.4% of this provider’s total Medicaid revenue. Those three codes individually appear as 43239: $39.8K (34.7%), 99203: $20K (17.4%), and 99204: $17.5K (15.3%), so a small set of services drives the majority of revenue.

The mix of high-revenue codes indicates a gastroenterology-focused, procedure-forward practice: 43239 (EGD with biopsy) and 45385 (colonoscopic polypectomy) are the leading procedure codes, while 99203, 99204 and 99214 represent office/new-patient and established-patient evaluation and management tied to that procedural workload. This combination suggests the provider performs diagnostic and therapeutic endoscopy alongside outpatient consults and follow-up visits.

43239 is the single largest Medicaid line: 150 claims producing $39.8K (34.7% of Medicaid revenue), and the code ranks #1 of 2 providers in-state (100th percentile; typical, unremarkable volume for this code). That ranking and volume profile mark it as the practice’s core clinical activity within the state peer set.

45385 (colonoscopic polypectomy) is a meaningful secondary procedure line with 44 claims and $15.4K (13.5% of Medicaid revenue); it ranks #2 of 2 providers in-state (0th percentile; typical, unremarkable volume). The small peer set and modest claim count suggest limited in-state competition for that specific procedure but overall modest throughput.

Office evaluation and management codes together represent a sizeable portion of revenue and reflect outpatient evaluation work: 99203 (210 claims, $20K; ranks #7 of 20 in-state, 68th percentile; typical, unremarkable volume), 99204 (125 claims, $17.5K; ranks #11 of 25 in-state, 58th percentile; typical, unremarkable volume), and 99214 (198 claims, $15.8K; ranks #32 of 43 in-state, 26th percentile; typical, unremarkable volume). These rank/percentile combinations portray the provider as a routine, non-dominant participant in office-based GI evaluation relative to state peers.

One notable line item is G0500: the record shows 33 claims with $0 avg paid/claim and $0 revenue, and it ranks #1 of 1 in-state (0th percentile; no state peer volume comparison available). The presence of billed but unpaid/zero-revenue claims for a moderate-volume sedation supervision code is a data point warranting further review or clarification by analysts (billing policy, bundling, or adjudication may explain the zero revenue).

Overall competitive characterization: with $114.5K in Medicaid revenue and no Medicare billing, this entity is a modest, locally oriented gastroenterology specialist rather than a major statewide payer-market competitor. The code-level ranks and percentiles are mostly mid-to-low, reinforcing that this practice occupies a routine, service-focused niche in its in-state peer set.

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	150	$270	$39.8K
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…	210	$100	$19.9K
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…	130	$140	$17.5K
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…	200	$80	$15.8K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	40	$350	$15.4K
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…	90	$60	$6K
G0500	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence…	30	$0	$0

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

St Croix Gastroenterology Center LLC — 1 of 6 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

7 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…	32	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…	30	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…	11	30	80	$150	$27K
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…	7	20	80	$90	$27K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1	10	90	$220	$19.8K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	2	10	50	$160	$7.7K
G0500	Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence…	1	10	30	$1	$10

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Croix Gastroenterology Center LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Raymond Cintron	VI	Gastroenterology Physician	$67.6K	$0
Jozette Matthews	VI	Family Nurse Practitioner	$13.9K	$0

Nearby Providers

Other providers in the same ZIP code as St Croix Gastroenterology Center LLC, ranked by combined Medicare and Medicaid revenue.

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

St Croix Gastroenterology Center LLC — Billing Profile & Reimbursement Data

Sign up for St Croix Gastroenterology Center LLC — Billing Profile & Reimbursement Data policy alerts

St Croix Gastroenterology Center LLC — Billing Profile & Reimbursement Data

Sign up for St Croix Gastroenterology Center LLC — Billing Profile & Reimbursement Data policy alerts

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