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NPI 1164741781 · St Thomas, VI · Obstetrics & Gynecology Physician
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Denita Boschulte is a obstetrics & gynecology physician provider located in St Thomas, U.S. Virgin Islands. This profile covers 4 Medicare and 4 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 | Individual |
| Organization | Denita Boschulte |
| Address | 9149 Estate Thomas Ste 204 |
| City | St Thomas |
| State | VI |
| ZIP | 00802 |
| Taxonomy | Obstetrics & Gynecology Physician |
| NPI Enumerated | May 21, 2010 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $63.8K |
| Medicare | $13.5K |
Provider profile and tenure: DENITA BOSCHULTE is listed as an Obstetrics & Gynecology Physician with an NPI enumerated on 2010-05-21 (~16 years ago). The billing footprint available includes both Medicare and Medicaid activity, with recorded lifetime Medicare revenue of $13.5K and lifetime Medicaid revenue of $63.8K.
Revenue concentration is high for both payers: the top three Medicare codes (99214, 99215, 99204) account for 89.6% of this provider's total Medicare revenue, and the top three Medicaid codes (99214, 99354, 99204) account for 98.2% of total Medicaid revenue. These shares indicate the provider relies on a very small set of codes for the vast majority of payer-reported income.
Business/service-line implication: the dominant codes across payers are evaluation-and-management office visits — notably 99214 and 99215 for established patients and 99204 for new patients — which suggests an ambulatory OBGYN practice focused on moderate-to-high complexity outpatient visits. The presence of 99354 on the Medicaid side points to use of prolonged-service add-on billing for extended encounters, indicating some visits exceed standard time thresholds.
Payer mix and scale: Medicaid materially exceeds Medicare in reported revenue for this provider, with $63.8K in Medicaid versus $13.5K in Medicare, making Medicaid the primary revenue source among the two payers on file. This pattern suggests the provider’s payer concentration is effectively Medicaid-dominant in scale, rather than being balanced between Medicare and Medicaid.
Medicare competitive standing and utilization detail: 99214 is the top Medicare code with 68 claims, $88 avg paid/claim and $6K revenue (44.3% of this provider's total Medicare revenue) and ranks #300236 of 479517 providers nationally (37th percentile), while 99215 contributes $4.7K (34.9%) and ranks #72090 of 145531 providers nationally (49th percentile). These ranks and the descriptive label “typical, unremarkable volume” indicate the provider is a modest, non-dominant national participant for these common E/M services.
Medicaid competitive standing and utilization detail: 99214 drives the bulk of Medicaid revenue with 442 claims, $116 avg paid/claim and $51.3K revenue (80.4% of this provider's total Medicaid revenue) and ranks #27 of 43 providers in-state (38th percentile), showing typical in-state volume rather than dominance. The Medicaid-only code 99354 generates $7.3K (11.4%) from 54 claims and ranks #4 of 4 providers in-state (0th percentile), indicating this provider is one of a very small group billing that code in-state but ranks low within that tiny set.
Statistical-outlier and coding-mix nuance: 99204 appears on both payers and contributes meaningfully to each payer’s revenue mix despite low comparative ranks — on Medicare it accounts for $1.4K (10.4%) and ranks #217464 of 227068 providers nationally (0th percentile, described as typical/unremarkable). On Medicaid 99204 produces $4.1K (6.4%) and ranks #22 of 25 providers in-state (13th percentile). These patterns suggest the provider sees a measurable volume of new-patient moderate-complexity visits even though relative ranking among peers is low.
Operational implication and scale context: the combination of heavy reliance on 99214/99215 office visits and a Medicaid use of 99354 prolonged service billing implies day-to-day operations are centered on ambulatory follow-up and extended outpatient encounters rather than high-volume procedural or inpatient work. Given the absolute reported totals ($13.5K Medicare and $63.8K Medicaid), the overall payer-reported revenue scale is modest, so strategic or contracting discussions should consider a small but concentrated outpatient E/M footprint.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 70 | $90 | $6K |
| 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… | 40 | $120 | $4.7K |
| 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 | $130 | $1.4K |
| 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… | 20 | $60 | $1.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.
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.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | 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… | 440 | $120 | $51.3K |
| 99354 | N/A | 50 | $140 | $7.3K |
| 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… | 30 | $160 | $4.1K |
| 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… | 10 | $90 | $1.1K |
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
4 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… | 27 | 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… | 39 | 40 | 430 | $110 | $260.9K |
| 99354 | N/A | 4 | 10 | 730 | $130 | $92.6K |
| 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… | 22 | 30 | 80 | $150 | $27K |
Other providers in the same ZIP code as Denita Boschulte, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Duanne Jones | VI | Public Health Dentistry | $0 | $33.2M |
| 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 |
| Comprehensive Orthopedics LLC | VI | Specialist | $0 | $1.1M |
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