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.

Department Of Health (NPI 1760752836)

Key Findings

Field	Value
Entity Type	Organization
Organization	Department Of Health
Address	#78 1-2-3 Estate Contant
City	St Thomas
State	VI
ZIP	00802
Taxonomy	Ambulatory Family Planning Facility
NPI Enumerated	January 6, 2012

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

This provider is effectively single-payer in scope: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $1.3M, indicating Medicaid is the sole recorded public payer driving its measurable billing activity. Analysts should treat any Medicare comparisons as inapplicable for this entity given the absence of Medicare claims.

Revenue is highly concentrated in three E/M codes: the precomputed top-3 Medicaid codes account for 71.8% of this provider's Medicaid revenue, led by 99215 ($401.9K, 30.8%), 99214 ($395.4K, 30.3%), and 99212 ($140.9K, 10.8%). This concentration means the provider’s financial performance on Medicaid is driven primarily by office/outpatient evaluation-and-management encounters rather than procedure or device billing.

The code mix aligns with the listed taxonomy (Ambulatory Family Planning Facility): high-volume E/M services (99215, 99214, 99212) together with contraceptive injection J1050 (1.5K claims, $112.9K, 8.6%) and point-of-care lab work (87210, 81025) point to a clinic model focused on ongoing family-planning encounters, contraception administration, pregnancy testing, and basic diagnostic wet-mount and urine testing. These patterns indicate in‑clinic episodic care and same-day services typical for family planning and reproductive health workflows.

Competitive standing by code shows a dominant position for the highest-acuity E/M code: 99215 ranks #1 of 17 providers in-state (100th percentile) and is described as notably above typical state volume for this code, suggesting this site captures a disproportionate share of high-complexity established-patient visits in its market. By contrast, 99214 ($395.4K, 30.3%) ranks #8 of 43 (83th percentile) and is labeled typical/unremarkable, and 99212 ($140.9K, 10.8%) ranks #3 of 16 (87th percentile) and is also typical, which together suggest leadership at the high end of E/M intensity with more typical volumes at mid/low E/M levels.

Several lab and procedure codes show heavy throughput consistent with clinic workflows: 87210 has 3.6K claims ($64.6K, 4.9%) and ranks #1 of 3 providers in-state (100th percentile; typical, unremarkable volume), while 81025 has 2.4K claims ($63.8K, 4.9%) and ranks #4 of 7 (50th percentile). These volumes indicate frequent point-of-care testing (wet mounts and pregnancy tests) that support the high visit counts rather than driving large per-procedure revenue.

Reimbursement per encounter emphasizes E/M payment levels rather than high-cost procedures: average paid per claim for top codes is $166 for 99215 and $146 for 99214, while contraceptive injection J1050 averages $73 per claim. This mix suggests revenue growth will scale mostly with visit volume and visit acuity rather than changes in high-dollar ancillary services.

The provider shows strong in-state positioning for specific, high-volume family-planning items: J1050 ranks #1 of 3 providers in-state (100th percentile; typical, unremarkable volume) and 87210 also ranks #1 of 3 (100th percentile; typical, unremarkable volume), reinforcing that the clinic is a primary site for contraception administration and basic diagnostic testing within its limited state peer set. However, several other codes (for example 81025 at the 50th percentile and 88164 at the 50th percentile) reflect only middling competitive standing for some ancillary lab services.

Operational tenure is well-established: the NPI was enumerated/registered on 2012-01-06 (~14 years ago), indicating the clinic has been active long enough to build recurring Medicaid patient flows. At the same time, the heavy dependence on a narrow set of E/M codes (top 3 = 71.8% of Medicaid revenue) creates revenue concentration exposure to changes in Medicaid utilization patterns or policy decisions that affect office visit reimbursement or visit coding practices.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,420	$170	$401.9K
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…	2,710	$150	$395.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,330	$110	$140.9K
J1050	Injection, medroxyprogesterone acetate, 1 mg	1,550	$70	$112.9K
87210	The lab analyst or microbiologist performs a wet mount preparation of a specimen, usually from material collected on a swab or placed directly on a microscope slide.	3,590	$20	$64.6K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	2,360	$30	$63.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	610	$60	$36.5K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	1,830	$20	$31K
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…	1,700	$20	$30.6K
88164	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology slide by screening it manually. He performs the test under a physician’s supervision and reports the…	830	$20	$15.8K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other U.S. Virgin Islands providers billing the same CPT/HCPCS codes.

Claims Volume vs. U.S. Virgin Islands Distribution

Department Of Health — 4 of 11 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. U.S. Virgin Islands median

11 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…	8	40	560	$140	$322K
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…	1	20	200	$150	$93.5K
81025	The lab analyst performs the pregnancy test on a urine specimen using a methodology or kit that the analyst can read visually for a direct readout.	4	10	2,360	$30	$71.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3	20	130	$110	$64.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	4	10	470	$40	$51.6K
J1050	Injection, medroxyprogesterone acetate, 1 mg	1	10	50	$70	$38.9K
88164	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology slide by screening it manually. He performs the test under a physician’s supervision and reports the…	2	10	830	$30	$26.1K
87210	The lab analyst or microbiologist performs a wet mount preparation of a specimen, usually from material collected on a swab or placed directly on a microscope slide.	1	10	150	$20	$22.2K
99441	N/A	2	10	280	$40	$21K
99070	Then provider utilizes items or supplies materials to the patient in excess of what is normally utilized or provided during an encounter. These items might include medical supplies, medications,…	1	10	930	$20	$15.5K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Department Of Health, Ems Stx	VI	Land Ambulance	$0	$2.2M
Dept Of Health, Govt Of Vi Ems St Thomas	VI	Land Ambulance	$0	$1.5M
Dept Of Health, Government Of The Virgin Islands	VI	Public Health or Welfare Agency	$0	$1.2M
Department Of Health, Govt Of Vi/mch Clinic Elaine Co	VI	Public Health or Welfare Agency	$0	$407.4K
Department Of Health, Rls Community Health Center	VI	Public Health or Welfare Agency	$0	$328.1K
Marc Jerome	VI	Gynecology Physician	$186.2K	$0
Michelle Dizon	VI	Endocrinology, Diabetes & Metabolism Physician	$92.2K	$0
Tai Hunte	VI	Infectious Disease Physician	$15.9K	$8.7K
Jozette Matthews	VI	Family Nurse Practitioner	$13.9K	$0
Jong Park	VI	Emergency Medicine Physician	$9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duanne Jones	VI	Public Health Dentistry	$0	$33.2M
Vi Government Hospital And Health Facilities Corp	VI	General Acute Care Hospital	$0	$23.6M
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
Vi Oral Surgery, Inc	VI	Oral and Maxillofacial Surgery (Dentist)	$0	$1.4M
Comprehensive Orthopedics LLC	VI	Specialist	$0	$1.1M

Department Of Health — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References