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NPI 1356425045 · St Thomas, VI · Clinical Medical Laboratory
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Community Medical Laboratory, Inc. is a clinical medical laboratory provider located in St Thomas, U.S. Virgin Islands. This profile covers 88 Medicare and 33 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 | Community Medical Laboratory, Inc. |
| Address | 9149 Estate Thomas |
| City | St Thomas |
| State | VI |
| ZIP | 00802 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | October 25, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $245.8K |
| Medicaid | $70.8K |
COMMUNITY MEDICAL LABORATORY, INC. appears to operate as a general outpatient clinical laboratory focused on routine diagnostic panels and phlebotomy: its Medicare top codes are 36415 (4.2K claims), 80053 (2.7K claims), and 80061 (1.9K claims), and the Medicaid top codes include the same core services. High claim counts for 36415 across both payers (Medicare 4.2K claims, Medicaid 3.6K claims) alongside large volumes of CMP (80053), lipid panel (80061), CBC (85025), A1C (83036), and TSH (84443) indicate the lab primarily processes outpatient bloodwork and chronic disease monitoring tests rather than specialized anatomic pathology or esoteric reference testing.
Revenue concentration is meaningful within each payer: the precomputed top-three Medicare codes account for 39.0% of Medicare revenue, while the precomputed top-three Medicaid codes account for 41.6% of Medicaid revenue. For Medicare, the top three drivers cited are 36415 ($29.5K, 14.2%), 80053 ($26.8K, 12.9%), and 80061 ($24.7K, 11.9%), and for Medicaid the top three are 36415 ($10.9K, 15.2%), 85025 ($10.1K, 14.0%), and 80053 ($8.9K, 12.4%).
Payer mix strongly favors Medicare in scale: lifetime Medicare revenue is $245.8K versus Medicaid revenue of $70.8K. Both payers are active, but Medicare is the larger source of billed revenue for this NPI based on the totals provided.
The provider’s Medicare coding profile shows relatively high national percentile placement for many routine codes, suggesting above-average volume among peers: 36415 ranks in the 100th percentile nationally, 80053 in the 98th percentile, and 80061 in the 98th percentile, yet the dataset labels for those codes are “typical, unremarkable volume,” implying the lab handles common tests at scale rather than performing unusual or highly specialized services. At the same time, Medicare code 81000 is flagged as “notably above typical national volume for this code,” marking a clear volume outlier for urinalysis relative to the national sample.
Within the in-state Medicaid competitive set the lab is generally a mid-tier participant for common panels: 36415 ranks #6 of 15 in-state (64th percentile) and 80053 ranks #6 of 12 (55th percentile), indicating routine market presence but not dominant statewide share for those lines. There are a few exceptions where the provider is a leading in-state source for a specific service despite small absolute revenue — notably 82043 (urine albumin) ranks #1 of 7 in-state (100th percentile) but represents only $518 (0.7% of Medicaid revenue).
The practice performs SARS–CoV–2 testing but at limited scale relative to its routine panels: Medicare includes 87426 ($4.4K) and 87635 ($4.1K), and Medicaid shows 87426 ($3.6K). These entries indicate the lab added COVID antigen/molecular testing to its mix but that such testing is a modest contributor to lifetime revenue compared with core chemistry and hematology codes.
Service-line mix and unit economics diverge between payers on identical services: for example, 36415 is reported with $7 avg paid/claim on Medicare (4.2K claims) but $3 avg paid/claim on Medicaid (3.6K claims), and similarly panels like 80053 show higher per-claim averages on Medicare than Medicaid. This pattern is consistent with a community lab that processes high volumes of low-complexity tests and experiences materially lower reimbursement per claim from Medicaid compared with Medicare.
The provider has been established on file for a long tenure, with NPI enumeration dated 2006-10-25 (~20 years ago), supporting that these billing patterns reflect an established local laboratory operation rather than a recent entrant or transient provider.
Medicare revenue breakdown by CPT/HCPCS procedure code.
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The CPT/HCPCS codes generating the most Medicare revenue for this provider.
88 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 4,220 | $10 | $29.5K |
| 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. | 2,680 | $10 | $26.8K |
| 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. | 1,900 | $10 | $24.7K |
| 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… | 2,590 | $10 | $20.7K |
| 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… | 1,140 | $20 | $18.3K |
| 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).… | 1,310 | $10 | $13.1K |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 570 | $20 | $10.3K |
| 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… | 220 | $30 | $6.3K |
| 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… | 320 | $20 | $5.1K |
| 81000 | 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… | 1,240 | $1 | $4.9K |
Showing 1–10 of 88
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 88 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.
33 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 3,630 | $1 | $10.9K |
| 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… | 2,510 | $1 | $10.1K |
| 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. | 2,220 | $1 | $8.9K |
| 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… | 1,100 | $10 | $8.8K |
| 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. | 1,420 | $10 | $7.1K |
| 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).… | 1,250 | $1 | $5K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 200 | $20 | $4.5K |
| 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,… | 150 | $30 | $3.6K |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 230 | $10 | $1.8K |
| 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… | 120 | $10 | $1.6K |
Showing 1–10 of 33
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
33 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 6 | 20 | 1,920 | $110 | $858.9K |
| 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. | 6 | 10 | 1,720 | $40 | $171.6K |
| 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,… | 5 | 10 | 260 | $120 | $95.3K |
| 87389 | The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an… | 3 | 10 | 1,360 | $40 | $68.7K |
| 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. | 6 | 10 | 2,520 | $20 | $61.3K |
| 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… | 6 | 10 | 2,510 | $20 | $57.8K |
| 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… | 7 | 10 | 2,510 | $10 | $45.4K |
| 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).… | 7 | 10 | 3,400 | $10 | $36.3K |
| 84439 | The lab analyst performs a test to measure free thyroxine, or free T4, typically in patient serum. | 6 | 10 | 1,330 | $20 | $26K |
| 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… | 6 | 10 | 450 | $40 | $21.9K |
Showing 1–10 of 33
Other providers in the same ZIP code as Community Medical Laboratory, Inc., ranked by combined Medicare and Medicaid revenue.
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