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NPI 1205978616 · Mayaguez, PR · Clinical Medical Laboratory
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Migrant Health Center Western Region,inc is a clinical medical laboratory provider located in Mayaguez, Puerto Rico. This profile covers 12 Medicare and 133 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 | Migrant Health Center Western Region,inc |
| Address | Calle Ramon Emeterio Bentances #497 Cond Bldg |
| City | Mayaguez |
| State | PR |
| ZIP | 00680 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | February 13, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $4.8M |
| Medicare | $5.2K |
This provider is effectively Medicaid‑centric: lifetime Medicaid revenue is $4.8M versus total Medicare revenue of $5.2K, which indicates the organization’s billing and service volume is overwhelmingly driven by Medicaid patients rather than Medicare. The disparity suggests the provider functions primarily within the state Medicaid ecosystem rather than as a significant Medicare lab vendor.
Medicare revenue is small and concentrated: the precomputed top 3 Medicare codes account for 45.9% of this provider’s Medicare revenue, led by 84443 ($848), 36415 ($812) and 80061 ($715). Each of those codes shows only modest national standing (for example, 84443 ranks #11536 of 19722 providers, 41th percentile; 80061 ranks in the 37th percentile), so the provider’s Medicare activity represents a low-volume, typical national footprint rather than a market-leading presence.
By contrast, Medicaid billing shows significant revenue concentration but distributed high-volume lines: the precomputed top 3 Medicaid codes account for 32.7% of Medicaid revenue and are driven by 84443 ($510.1K), 80061 ($443K) and 80053 ($355.2K). All three of those codes rank in the 99th percentile in-state (for example, 84443 ranks #8 of 771, 80061 ranks #7 of 810), characterizing the provider as an unusually large in-state operator for routine endocrine, lipid and metabolic testing.
The overall code mix indicates a community clinical laboratory and public‑health screening operation: high-revenue Medicaid services include endocrine testing (84443 TSH), metabolic and lipid panels (80053, 80061), hematology (85025 CBC) and vitamin testing (82306), while infectious disease and STI testing appear as material lines (87536 HIV viral load, 87591 GC NAAT, 87491 CT NAAT, 86592 syphilis, 86803 Hep C antibody). These specific codes and their large Medicaid claim volumes (for example, 84443: 31.9K claims; 80061: 34.1K claims; : 49.2K claims) point to high throughput laboratory processing and broad screening services.
Competitive standing is bifurcated by payer: nationally the provider’s Medicare volumes are modest and fall in middle percentiles for common lab codes (e.g., 36415 at the 56th percentile, 80053 at the 41th percentile), whereas in Puerto Rico the provider is a dominant statewide performer on many Medicaid codes (multiple 99th‑percentile and even 100th‑percentile ranks such as 82274 at 100th percentile and 86592 at 100th percentile). This pattern identifies the organization as a major in-state lab partner for Medicaid payers and public health programs while remaining a minor participant in the national Medicare lab market.
The provider’s Medicaid portfolio shows multiple statistical outliers in-state, reflecting concentrated strengths in specific test categories: examples include 82306 (vitamin D) listed as an "extreme outlier" at $226.6K, 86703 (HIV antibody) at $149K and ranked #2 of 182 in-state as an "extreme outlier," and 82274 (FIT test) with $187.4K and a 100th‑percentile rank. These labels and ranks indicate unusually large state volumes for both routine preventive screens and infectious disease testing compared with other in-state providers.
Operational throughput implications are clear from claim counts on Medicaid: very large claim volumes such as 49.2K claims for 85025, 35.5K claims for 80053, and 36.1K claims for 81001 imply centralized, high-frequency specimen processing capacity and likely reliance on standardized panels and automated analyzers. In contrast, the provider’s Medicare claim counts and dollars are minimal, reinforcing that operational scale is directed at Medicaid business rather than Medicare.
The provider has a long-established billing presence: NPI was enumerated on 2007-02-13 (~19 years ago). That tenure, combined with the provider’s in‑state dominance on many Medicaid lab codes, suggests established contracts or referral relationships within Puerto Rico’s Medicaid network and public health screening programs.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 50 | $20 | $850 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 120 | $10 | $810 |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 60 | $10 | $720 |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 70 | $10 | $660 |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 80 | $10 | $630 |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 10 | $30 | $410 |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 40 | $10 | $370 |
| G0328 | Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous | 10 | $20 | $250 |
| 81001 | Urinalysis is used to detect substances or cellular material in the urine associated with different metabolic and kidney disorders. It is used to detect urinary tract infections (UTI) and other… | 60 | $1 | $190 |
| 80048 | The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood… | 10 | $10 | $110 |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
133 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 31,880 | $20 | $510.1K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 34,080 | $10 | $443K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 35,520 | $10 | $355.2K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 49,190 | $10 | $344.3K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 7,220 | $40 | $303.2K |
| 82306 | The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced… | 12,590 | $20 | $226.6K |
| 82274 | The lab analyst uses an immunoassay method to perform a test for hidden blood in a fecal specimen that the patient collects from three consecutive bowel movements or that the clinician acquires… | 12,490 | $20 | $187.4K |
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 2,140 | $90 | $181.9K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 17,290 | $10 | $155.6K |
| 86703 | The lab analyst performs an immunoassay to evaluate the patient’s specimen, typically serum, for antibodies to HIV 1 or HIV 2. This code applies to a single result for either antibody. | 13,550 | $10 | $149K |
Showing 1–10 of 133
How this provider's Medicaid billing volume and revenue compare to other Puerto Rico providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Puerto Rico median
133 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 87536 | A lab tests a patient’s specimen to measure the amount of HIV–1 present. This may be referred to as viral load. | 6 | 40 | 250 | $80 | $140.8K |
| 87426 | The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,… | 40 | 650 | 1,260 | $40 | $93.7K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 8 | 770 | 2,520 | $20 | $65.5K |
| 87635 | Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus… | 112 | 370 | 370 | $50 | $63.3K |
| 87590 | The lab analyst performs a test for Neisseria gonorrhoeae, a bacteria, using direct nucleic acid probe technique. | 7 | 80 | 150 | $20 | $59.4K |
| 86360 | The lab analyst performs a test to measure the number of CD4 and CD8 cells, typically in a blood specimen, including a calculation of the ratio between the two. The provider may order a CD4, CD8 and… | 10 | 30 | 320 | $40 | $58.5K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 7 | 810 | 2,350 | $10 | $52.7K |
| 87591 | The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique. | 25 | 290 | 170 | $30 | $43.8K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 27 | 310 | 190 | $30 | $43.1K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 8 | 790 | 2,360 | $10 | $41.9K |
Showing 1–10 of 133
Other providers in the same ZIP code as Migrant Health Center Western Region,inc, ranked by combined Medicare and Medicaid revenue.
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