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.

Clayton Wheatley (NPI 1104920594)

Field	Value
Entity Type	Individual
Organization	Clayton Wheatley
Address	Schneider Regional Medical Medical Center
City	St. Thomas
State	VI
ZIP	00802
Taxonomy	Emergency Medicine Physician
NPI Enumerated	September 7, 2006

Payer Source	Total Paid
Medicare	$18.5K
Medicaid	$0

Key Findings

CLAYTON WHEATLEY is credentialed as an Emergency Medicine Physician and the Medicare billings are dominated by emergency department evaluation & management services (codes 99283, 99284, 99285). The provider’s lifetime Medicare revenue is $18.5K and the precomputed top-3 Medicare codes account for 86.4% of that total, indicating an ED-focused service mix concentrated in a narrow set of E/M codes.

Revenue concentration is high: the three highest-revenue Medicare codes (99283, 99284, 99285) together constitute 86.4% of this provider’s Medicare revenue, which points to dependence on a small set of ED E/M services for almost all reported Medicare income. Given the small absolute lifetime Medicare revenue ($18.5K), this concentration amplifies the operational impact of coding and volume shifts for a modest-scale Medicare footprint.

Code-level volume and payment details show an unusual profile for lower-acuity ED visits: 99283 has 147 claims, $45 avg paid/claim, $6.6K revenue (35.8% of Medicare revenue) and ranks #186 of 31069 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). This ranking indicates unusually high national volume for 99283 relative to peers, making it the single largest revenue driver for this provider.

A second statistical outlier appears at the low/straightforward acuity level: 99282 has 105 claims, $24 avg paid/claim, $2.5K revenue (13.6% of Medicare revenue) and ranks #42 of 3059 providers nationally (99th percentile; extreme outlier). The combination of extreme outlier status on both 99283 and 99282 suggests this clinician’s Medicare ED activity is disproportionately weighted toward lower-complexity E/M encounters compared with national peers.

Higher-acuity ED codes are present but not exceptional in national context: 99284 (73 claims, $82 avg paid/claim, $6K revenue; 32.4% of Medicare revenue) ranks #25748 of 64306 (59th percentile; typical, unremarkable volume) and 99285 (27 claims, $125 avg paid/claim, $3.4K revenue; 18.2% of Medicare revenue) ranks #52408 of 61347 (14th percentile; typical, unremarkable volume). These patterns indicate that while moderate and high complexity ED visits contribute materially to revenue, their volumes are within expected ranges for national peers.

Payer mix is effectively single-payer Medicare: there is no Medicaid billing on file for this provider. Analysts should treat this entity as having no recorded Medicaid exposure when modeling local payer mix, network capacity, or Medicaid-specific risk and reimbursement dynamics.

The NPI was enumerated on 2006-09-07 (~20 years ago), indicating long-standing enrollment with Medicare. Combined with the small lifetime Medicare revenue, this tenure suggests either a low-volume Medicare practice or a panel skewed toward non‑Medicare payers (e.g., commercial, uninsured, or local payers) or intermittent Medicare-covered activity in an ED staffing model.

For competitive and utilization review, focus follow-up on the unusually high counts of lower-acuity ED codes (99283 and 99282) relative to national peers and confirm the clinical setting (site of service, shift coverage model) and patient-mix drivers. Given top-code concentration and modest total Medicare dollars, targeted verification of coding mixes and local ED volumes will yield the most actionable insights for contracting or utilization management decisions.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	150	$50	$6.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	70	$80	$6K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	30	$130	$3.4K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	110	$20	$2.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. U.S. Virgin Islands Distribution

Clayton Wheatley — 1 of 4 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. state median

4 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	4	10	80	$120	$10.1K
99284	3	10	60	$80	$5.3K
99282	1	10	110	$20	$2.5K
99283	1	10	20	$50	$2.1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Clayton Wheatley, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vi Government Hospital And Health Facilities Corp	VI	General Acute Care Hospital	$0	$23.6M
Kevin Stewart	VI	Ophthalmology Physician	$469.5K	$0
Walter Rohloff	VI	Nephrology Physician	$85.2K	$100.3K
Leslie Kingslow	DC	Pulmonary Disease Physician	$176.8K	$0
James Gasho	MD	Orthopaedic Surgery Physician	$172.1K	$0
Reva Richardson	VI	Internal Medicine Physician	$154.4K	$0
James Nelson	VI	Neurology Physician	$143.2K	$0
Jeanette Dilan-koetje	MO	Internal Medicine Physician	$133.6K	$0
David Weisher	VI	Medical Specialty Clinic/Center	$103.3K	$0
John Shuster	WA	Orthopaedic Surgery of the Spine Physician	$101.4K	$0

Nearby Providers

Other providers in the same ZIP code as Clayton Wheatley, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duanne Jones	VI	Public Health Dentistry	$0	$33.2M
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
Department Of Health	VI	Ambulatory Family Planning Facility	$0	$1.3M

Clayton Wheatley — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References