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 Thomas Neurology PLLC (NPI 1023361052)

Field	Value
Entity Type	Organization
Organization	St Thomas Neurology PLLC
Address	9149 Estate Thomas Ste 209
City	St Thomas
State	VI
ZIP	00802
Taxonomy	Neurology Physician
NPI Enumerated	October 15, 2012

Payer Source	Total Paid
Medicaid	$117.7K
Medicare	$0

Key Findings

ST THOMAS NEUROLOGY PLLC shows effectively single-payer activity in the available data set: there is no Medicare billing on file while total Medicaid revenue is $117.7K. The absence of Medicare revenue suggests analyses of payer mix and competitive position should focus primarily on Medicaid flows and in-state comparisons rather than national Medicare benchmarks.

Revenue concentration is high within a small set of evaluation-and-management codes: the top 3 Medicaid codes by revenue (99213, 99205, 99214) account for 75.0% of this provider's total Medicaid revenue. Individually, 99213 generated $38.2K (32.5%), 99205 generated $25.7K (21.8%), and 99214 generated $24.3K (20.6%) of Medicaid revenue, indicating dependence on routine outpatient E/M visits for the bulk of receipts.

The code mix—predominantly 99213, 99205, and 99214—is consistent with an outpatient neurology practice delivering new-patient and established-patient evaluation and management services, with 95816 (EEG) also appearing in the top codes. The presence of 95816 (80 claims, $12.8K, 10.9%) supports that diagnostic EEG services are part of the clinical offering rather than a purely consultative or referral-only practice.

Competitive standing on the highest-volume code, 99213, is middle-of-pack: 99213 ranks #18 of 41 providers in-state (57th percentile; typical, unremarkable volume for this code). This suggests the practice captures a standard share of routine established-patient visits locally rather than leading that segment.

For higher-complexity new-patient visits coded as 99205, the provider records 142 claims and $25.7K (21.8%) and ranks #4 of 7 in-state (50th percentile; typical, unremarkable volume for this code), indicating modest participation in high-complexity new evaluations within a small peer group. The 50th percentile placement implies the practice neither under-indexes nor over-indexes relative to the limited set of in-state peers reporting that code.

The 99214 volume ($24.3K, 20.6%) ranks #30 of 43 providers in-state (31th percentile; typical, unremarkable volume for this code), placing the practice below the state median for moderate-complexity established visits. Combined with the 99213 position, this pattern points to steady primary outpatient visit activity but not dominance in moderate-complexity follow-up care.

Hospital-based initial care is present but limited: 99223 accounts for $13K (11.1%) with 82 claims and ranks #2 of 4 in-state (67th percentile; typical, unremarkable volume for this code), indicating some engagement with inpatient or observation-level E/M services but within a small subset of providers who bill that code. This suggests occasional hospital-based consults or admissions rather than a primary inpatient-service line.

The EEG code 95816 appears as $12.8K (10.9%) of revenue and 80 claims, and it ranks #1 of 1 providers in-state (0th percentile; no state peer volume comparison available). That combination—meaningful share of Medicaid revenue plus being the sole in-state reporter in the dataset—flags EEG as a notable capability of the practice, though the lack of peer data limits conclusions about relative market share. The NPI was enumerated 2012-10-15 (~14 years ago), indicating an established presence in the registry despite modest Medicaid revenue scale.

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
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…	540	$70	$38.2K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	140	$180	$25.7K
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…	280	$90	$24.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	80	$160	$13K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	80	$160	$12.8K
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…	10	$170	$2.1K
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…	40	$50	$1.6K

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 Thomas Neurology PLLC — 0 of 7 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…	30	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…	18	40	430	$110	$260.9K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	4	10	140	$240	$42.7K
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…	5	10	430	$50	$41.4K
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…	25	30	80	$150	$27K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2	10	60	$130	$14.1K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	1	10	80	$160	$12.8K

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Thomas Neurology PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Weisher	VI	Medical Specialty Clinic/Center	$103.3K	$0

Nearby Providers

Other providers in the same ZIP code as St Thomas Neurology PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duanne Jones	VI	Public Health Dentistry	$0	$33.2M
Vi Government Hospital And Health Facilities Corp	VI	General Acute Care Hospital	$0	$23.6M
The St Thomas East End Medical Center Corporation	VI	Federal Public Health Clinic/Center	$0	$12.8M
Aac-air Ambulance Caribbean Inc.	VI	Air Ambulance	$2M	$8.6M
Vi Relocation Services And Rentals LLC	VI	Land Ambulance	$0	$6.8M
Alicia Prentice	VI	Home Health Aide	$0	$3.9M
Stretcher Plus, LLC	VI	Non-emergency Medical Transport (VAN)	$0	$2.8M
Cog Restore, LLC	VI	Rehabilitation Clinic/Center	$0	$2.1M
Dept Of Health, Govt Of Vi Ems St Thomas	VI	Land Ambulance	$0	$1.5M
Vi Oral Surgery, Inc	VI	Oral and Maxillofacial Surgery (Dentist)	$0	$1.4M

St Thomas Neurology PLLC — Billing Profile & Reimbursement Data

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St Thomas Neurology PLLC — 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