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NPI 1083948186 · St. Thomas, VI · Public Health or Welfare Agency
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Department Of Health, Govt Of Vi/mch Clinic Elaine Co is a public health or welfare agency provider located in St. Thomas, U.S. Virgin Islands. This profile covers 0 Medicare and 14 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 | Organization |
| Organization | Department Of Health, Govt Of Vi/mch Clinic Elaine Co |
| Address | 2 C Contant, Aq Bldg 2nd Floor |
| City | St. Thomas |
| State | VI |
| ZIP | 00802 |
| Taxonomy | Public Health or Welfare Agency |
| NPI Enumerated | September 23, 2009 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $407.4K |
| Medicare | $0 |
This provider is effectively single‑payer in the available claims data: Total Medicare revenue: none (no Medicare billing on file) while Total Medicaid revenue: $407.4K, indicating all documented fee‑for‑service volume comes from Medicaid. Analysts should therefore treat Medicaid patterns as representative of the organization’s billing footprint rather than a mixed Medicare/Medicaid practice mix.
Revenue concentration is high: the precomputed top 3 Medicaid codes by revenue account for 61.0% of this provider's total Medicaid revenue, with 99392 alone contributing $133.3K (32.7%). This concentration signals that a small set of preventive and evaluation codes are driving the majority of Medicaid payments.
The code mix emphasizes preventive care and routine primary‑care evaluation and management. High‑revenue codes include 99392 ($133.3K, preventive medicine reevaluation), 99214 ($59.3K, established patient E/M), and 99391 ($55.9K, preventive medicine for new patients), which together reflect a practice model focused on well visits, screenings, and moderate‑complexity office visits rather than specialized procedures.
Vaccination services are a material secondary service line: 90471 appears on 2.6K claims for $41.2K (10.1% of Medicaid revenue) and ranks #1 of 7 providers in-state (100th percentile; notably above typical state volume for this code). That high volume of vaccine administration aligns with a public‑health clinic role delivering immunizations at scale.
Competitive standing across most high‑revenue codes is modest within the state. For example, 99392 ranks #4 of 6 providers in-state (40th percentile) and 99214 ranks #23 of 43 providers in-state (48th percentile), both characterized as "typical, unremarkable volume for this code," indicating the provider is not a dominant in‑state leader for core E/M or preventive codes despite meaningful revenue.
Some pediatric preventive activity is present but limited compared with peers: 99393 appears with $39K revenue (9.6% of Medicaid revenue) and ranks #4 of 4 providers in-state (0th percentile; typical, unremarkable volume), suggesting the clinic provides established well‑child visits but is a low‑volume performer versus state peers for that specific code.
The practice also bills a mix of low‑revenue lab and ancillary codes, such as 81002 ($4.8K) and 81025 ($4.9K), and contraceptive injections like J1050 ($3.1K). These smaller revenue streams reinforce a community health clinic profile that pairs preventive visits and vaccinations with point‑of‑care testing and basic reproductive health services.
The organization has longstanding enrollment in national provider registries (NPI enumerated: 2009-09-23 (~17 years ago)), indicating operational tenure that supports sustained Medicaid billing relationships; however, the absence of any Medicare claims on file means competitive analysis and network strategy should be framed exclusively around Medicaid participation and local public‑health service roles.
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.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,430 | $90 | $133.3K |
| 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… | 540 | $110 | $59.3K |
| 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… | 620 | $90 | $55.9K |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 2,580 | $20 | $41.2K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 320 | $120 | $39K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 470 | $60 | $28.3K |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 470 | $30 | $16K |
| 99215 | The provider sees an established 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… | 200 | $60 | $12.1K |
| 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… | 220 | $40 | $8.6K |
| 81025 | The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout. | 200 | $30 | $4.9K |
Showing 1–10 of 14
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
14 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… | 23 | 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… | 27 | 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… | 4 | 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… | 4 | 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. | 4 | 10 | 960 | $160 | $154.2K |
| 99215 | The provider sees an established 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… | 9 | 20 | 200 | $150 | $93.5K |
| 81025 | The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout. | 5 | 10 | 2,360 | $30 | $71.7K |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 6 | 20 | 130 | $110 | $64.8K |
| 99211 | An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional. | 6 | 10 | 470 | $40 | $51.6K |
| 81002 | The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen… | 5 | 10 | 850 | $10 | $49.8K |
Showing 1–10 of 14
Other providers in the same ZIP code as Department Of Health, Govt Of Vi/mch Clinic Elaine Co, ranked by combined Medicare and Medicaid revenue.
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