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NPI 1891799763 · St Thomas, VI · Federal Public Health Clinic/Center
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The St Thomas East End Medical Center Corporation is a federal public health clinic/center provider located in St Thomas, U.S. Virgin Islands. This profile covers 0 Medicare and 103 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 | The St Thomas East End Medical Center Corporation |
| Address | 4605 Tutu Park Mall |
| City | St Thomas |
| State | VI |
| ZIP | 00802 |
| Taxonomy | Federal Public Health Clinic/Center |
| NPI Enumerated | June 9, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $12.8M |
| Medicare | $0 |
This provider has no Medicare billing on file and reports $12.8M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid-focused) operation in the available claims data. Analysts should treat Medicaid as the primary and nearly exclusive revenue stream when modeling this entity's payer exposure and risk.
Revenue is heavily concentrated in a small set of outpatient evaluation/management and behavioral-health codes: the precomputed top 3 Medicaid codes by revenue account for 54.2% of the provider's total Medicaid revenue, driven primarily by 99214 (27.4%), 99213 (17.7%), and 90837 (9.0%). This concentration indicates that a majority of Medicaid dollars flow from a few high-volume ambulatory service lines rather than a broad mix of specialty procedures.
The provider’s taxonomy as a Federal Public Health Clinic/Center and the presence of G0467 (4K claims, $116.1K revenue) align with federally qualified health center–style operations, and the claims mix shows a combined primary care, preventive, behavioral-health, lab, immunization, and dental service profile. High counts for E/M codes alongside vaccination codes (90460/90461) and lab codes (81002, 81025, 87110) support a multi-service community health center model rather than a narrow specialty clinic.
On competitive standing in-state, the provider is a dominant volume contributor for several core outpatient E/M codes: 99214 ranks #2 of 43 providers in-state (98th percentile; extreme outlier, far above typical state volume for this code) and 99213 ranks #2 of 41 providers in-state (98th percentile; notably above typical state volume for this code). These rankings indicate the provider is among the top-volume ambulatory care sites in the state for moderate- and low-complexity established-patient visits and likely carries a large ambulatory patient panel.
Behavioral health services are a material part of the care mix: 90837 (4K claims, $1M revenue, 9.0% of Medicaid revenue) ranks #2 of 10 providers in-state (89th percentile; notably above typical state volume for this code), and the add-on 90833 also appears in the top codes. The presence of high-volume psychotherapy billing suggests integrated or co-located behavioral-health programs contributing meaningfully to overall Medicaid revenue.
Dental and oral-health services are an identifiable secondary service line: D1110 (4.4K claims, $420.1K revenue) and other dental codes such as D0330, D0140, D0150, and D7140 together represent several percent points each of Medicaid revenue and include multiple top rankings (e.g., D0330 ranks #1 of 8 providers in-state). This mix signals an on-site dental capability that supplements primary-care and preventive offerings, expanding the clinic’s scope of covered services for Medicaid members.
Pediatric and preventive care activity is visible across codes: 99392 (3.1K claims, $531.6K revenue) ranks #1 of 6 providers in-state (100th percentile; typical, unremarkable volume) and adolescent/child well visits 99391/99393 also appear in the top codes, while immunization codes 90460 and 90461 show thousands of claims. The combination of well-child visits, routine immunizations, and pregnancy testing (81025) points to a robust preventive and family-health focus within the clinic’s service mix.
This entity has an established presence with its NPI enumerated on 2005-06-09 (~21 years ago), and several individual codes show very large claim volumes—examples include 99214 at 18K claims, 99213 at 15.7K claims, and 81002 at 14.8K claims—indicating high patient throughput consistent with a long-standing community health center. Together, tenure plus sustained high volumes across basic E/M, lab, vaccine, behavioral-health, and dental codes suggest operational scale appropriate for regional Medicaid contracting and network planning.
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.
103 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… | 17,960 | $180 | $3.2M |
| 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… | 15,660 | $130 | $2.1M |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 3,960 | $260 | $1M |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 3,070 | $170 | $531.6K |
| 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,… | 3,870 | $120 | $460.9K |
| D1110 | Prophylaxis - adult; cleaning and polishing of the teeth | 4,380 | $100 | $420.1K |
| D0330 | N/A | 3,700 | $100 | $358.5K |
| D0140 | Limited oral evaluation – problem focused | 3,490 | $100 | $345.1K |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 2,100 | $160 | $340K |
| 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… | 1,230 | $270 | $333.5K |
Showing 1–10 of 103
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
103 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. | 8 | 20 | 1,920 | $110 | $858.9K |
| D2392 | Post 2 surface resin‑based composite | 6 | 10 | 520 | $230 | $376.2K |
| 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 | 40 | 560 | $140 | $322K |
| D7140 | Extraction, erupted tooth or exposed root (elevation and/or forceps removal) | 3 | 10 | 1,120 | $160 | $299.5K |
| 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… | 2 | 40 | 430 | $110 | $260.9K |
| 99391 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 2 | 10 | 2,030 | $150 | $248.7K |
| D2391 | Resin‑based composite – one surface, posterior | 5 | 10 | 190 | $180 | $232.4K |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 2 | 10 | 790 | $180 | $229K |
| 99392 | Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby… | 1 | 10 | 1,540 | $150 | $221.8K |
| D1330 | N/A | 4 | 10 | 3,530 | $50 | $185.5K |
Showing 1–10 of 103
Other providers in the same ZIP code as The St Thomas East End Medical Center Corporation, ranked by combined Medicare and Medicaid revenue.
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