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NPI 1407301401 · St Thomas, VI · Clinical Medical Laboratory
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St. Thomas Clinical Reference Laboratory is a clinical medical laboratory provider located in St Thomas, U.S. Virgin Islands. This profile covers 54 Medicare and 60 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 | St. Thomas Clinical Reference Laboratory |
| Address | Medical Complex |
| City | St Thomas |
| State | VI |
| ZIP | 00802 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | August 19, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $708.1K |
| Medicare | $106.5K |
ST. THOMAS CLINICAL REFERENCE LABORATORY presents as a clinical reference laboratory focused on routine chemistry, endocrine, hematology and infectious-disease testing: its Medicare top codes include 80061, 80053 and 84443 while its Medicaid top codes include 87635, 84443 and 80061. The Medicaid top-code mix shows a heavy operational role in COVID-19 molecular testing (87635) alongside high-volume panels like lipid and TSH testing, consistent with a lab that processes large volumes of outpatient specimens.
Revenue concentration is moderate but meaningful: the provider’s top three Medicare codes account for 33.1% of its Medicare revenue and the top three Medicaid codes account for 33.8% of its Medicaid revenue. This suggests that roughly one-third of billing for each payer is driven by a small set of common lab tests rather than a highly diffuse code mix.
The provider’s payer mix is Medicaid-dominant in scale: lifetime Medicaid revenue is $708.1K compared with lifetime Medicare revenue of $106.5K, indicating the majority of the facility’s billed volume and revenue comes from Medicaid. Analysts should treat the entity as effectively Medicaid-led for revenue and utilization patterns rather than Medicare-led.
National competitive standing on Medicare is mixed: several common panels show high national percentiles (for example, 80061 ranks #741 of 21671 providers nationally at the 97th percentile and 83036 ranks #776 of 44997 providers at the 98th percentile), but many Medicare line items are described as “typical, unremarkable volume.” In other words, the lab registers pockets of relatively strong national volume on routine chemistry and diabetes monitoring tests while overall Medicare activity remains modest in absolute revenue ($106.5K).
State-level competitive standing on Medicaid is comparatively strong for a number of core tests: 84443 and 80061 each rank #1 in-state (100th percentile), G2023 ranks #1 of 5 in-state (100th percentile), and 82306 and 81000 likewise rank #1 in-state with 81000 called out as notably above typical state volume for this code. These placements indicate the lab is a major in-state provider for routine TSH, lipid panels, specimen collection and several urine/chemistry tests.
Operational footprint includes large specimen-collection and high-volume screening activity: Medicaid shows 36415 with 11.5K claims and $34.6K revenue (5.0% of Medicaid revenue) and G2023 with 1.7K claims and $36.5K revenue (5.3% of Medicaid revenue), pointing to substantial specimen collection and COVID specimen processing capacity. Combined with high counts for panels such as 80053 and 85025 on Medicaid, the data are consistent with a lab that supports broad outpatient testing and community-collection sites.
Tenure on file is stable: the NPI was enumerated on 2016-08-19 (~10 years ago), indicating several years of operation reflected in the claims history and establishing a multi-year presence in both Medicare and Medicaid billing. Analysts should consider this established operational history when evaluating trends or contracting opportunities.
There are several state-level statistical notes and unique-service signals worth monitoring: a few Medicaid codes show “notably above typical” state volume (81000, 84436, 84479) and certain tests appear with no in-state peers for comparison (87590 and 86794 each rank #1 of 1 providers in-state with no state peer volume comparison available). These items suggest the lab either provides niche services locally or occupies singular reporting positions for specific infectious-disease and toxicology assays in the territory.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
54 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 940 | $10 | $12.2K |
| 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. | 990 | $10 | $9.8K |
| 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… | 590 | $20 | $9.4K |
| 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… | 920 | $10 | $7.4K |
| 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).… | 720 | $10 | $7.2K |
| 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… | 370 | $20 | $6.7K |
| 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… | 360 | $20 | $5.7K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 1,510 | $1 | $4.5K |
| 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… | 150 | $30 | $4.4K |
| 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… | 810 | $1 | $3.2K |
Showing 1–10 of 54
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 54 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.
60 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 1,680 | $50 | $80.6K |
| 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… | 5,290 | $20 | $79.3K |
| 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. | 6,010 | $10 | $72.1K |
| 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… | 8,920 | $10 | $62.4K |
| 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. | 6,770 | $10 | $60.9K |
| 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… | 2,510 | $20 | $55.3K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1,660 | $20 | $36.5K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 11,520 | $1 | $34.6K |
| 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… | 1,280 | $20 | $30.7K |
| 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).… | 3,530 | $10 | $28.2K |
Showing 1–10 of 60
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
60 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. | 4 | 20 | 1,920 | $110 | $858.9K |
| 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… | 3 | 10 | 1,020 | $110 | $229.8K |
| 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. | 5 | 10 | 1,720 | $40 | $171.6K |
| 87491 | The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique. | 3 | 10 | 560 | $70 | $130.2K |
| 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… | 2 | 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. | 1 | 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… | 1 | 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… | 3 | 10 | 2,510 | $10 | $45.4K |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1 | 10 | 340 | $50 | $39.8K |
| 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).… | 3 | 10 | 3,400 | $10 | $36.3K |
Showing 1–10 of 60
Other providers in the same ZIP code as St. Thomas Clinical Reference Laboratory, ranked by combined Medicare and Medicaid revenue.
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