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NPI 1972503647 · Christiansted, St. Croix, VI · General Acute Care Hospital
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Governor Juan F. Luis Hospital & Medical Center is a general acute care hospital provider located in Christiansted, St. Croix, U.S. Virgin Islands. This profile covers 0 Medicare and 166 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 | Governor Juan F. Luis Hospital & Medical Center |
| Address | #4007 Estate Diamond Ruby |
| City | Christiansted, St. Croix |
| State | VI |
| ZIP | 00821 |
| Taxonomy | General Acute Care Hospital |
| NPI Enumerated | July 26, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $15.4M |
| Medicare | $0 |
This provider is effectively single‑payer on file: there is no Medicare billing on file while Medicaid accounts for $15.4M in lifetime revenue. That concentration leaves the hospital dependent on Medicaid flows for its billed activity and negotiating leverage, and any changes in state Medicaid policy or rates would materially affect its revenue base.
Revenue is highly concentrated in a few outpatient/ancillary procedures: the precomputed top three Medicaid codes account for 52.6% of the provider’s total Medicaid revenue. The top three are 36415 ($5.2M, 37.6%), 99281 ($1.1M, 7.8%), and 96374 ($1M, 7.2%), indicating that a majority of dollars come from specimen collection, low‑level ED visits, and rapid IV medication administration.
The code mix points to a high‑throughput hospital outpatient platform with heavy lab and emergency activity. Dominant codes include 36415 (blood draws), high‑volume ED E/M codes (99281, 99282, 99283), and infusion/IV administration (96374), while diagnostic imaging and women’s health services such as 77063 ($860K) and 76805 ($488.4K) show the facility also runs substantial imaging and obstetric ultrasound services.
Competitive standing within the state is strong for several diagnostic and collection services: 36415 ranks #1 of 15 providers in‑state at the 100th percentile and 96374 ranks #1 of 2 at the 100th percentile. Multiple additional codes used for imaging and lab work (77063, 76805, 71046, 80053) also rank #1 in their peer sets at the 100th percentile, which together suggest the facility dominates outpatient diagnostic and specimen collection volume in its market.
Emergency department coding shows a small peer set but mixed positioning: ED E/M codes 99281, 99282, and 99283 are reported (e.g., 99283 has 16.8K claims with $25 avg paid/claim) yet many of those ED codes are reported only by 2 providers in‑state and are described as having typical or unremarkable volumes. This pattern implies the hospital provides substantial ED throughput but operates in a market with very few submitting peers for these specific ED codes, reducing within‑state competition on those items.
Several codes are flagged as “notably above typical” relative to state norms, highlighting statistical outlier status for throughput in lab and basic imaging. Examples include 36415 (notably above typical), 76805 (notably above typical), 81003 (notably above typical), and 80053 (notably above typical), which collectively indicate materially higher specimen collection and core lab/imaging volume than peers.
Operationally, the provider’s revenue profile is driven by very high‑frequency, lower‑unit‑paid services alongside some higher‑paid diagnostic procedures. For example, 36415 shows 28.4K claims at $185 avg paid/claim while high‑frequency lab panels like 80053 show 15.8K claims at $10 avg paid/claim, signaling a throughput model where volume of basic services drives a large share of dollars.
The provider has been enumerated for a long time (NPI registered 2005-07-26, ~21 years ago), which supports the view that its entrenched operations and sustained Medicaid activity have allowed it to build the high specimen collection, imaging, and ED volumes reflected in the billing profile. Longevity combined with the concentration of Medicaid revenue suggests strategic importance within the local safety‑net and diagnostic ecosystem.
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.
166 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. | 28,380 | $190 | $5.2M |
| 99281 | The provider sees a patient for the lowest level emergency department visit. | 4,800 | $230 | $1.1M |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 7,950 | $130 | $1M |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 8,330 | $110 | $875K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 2,680 | $320 | $860K |
| 76805 | In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks… | 1,780 | $280 | $488.4K |
| 81003 | The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will… | 12,320 | $40 | $480.3K |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 5,580 | $80 | $468.7K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 3,680 | $120 | $422.9K |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 16,840 | $30 | $421.1K |
Showing 1–10 of 166
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
166 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99281 | The provider sees a patient for the lowest level emergency department visit. | 2 | 10 | 6,090 | $210 | $1.3M |
| 99282 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making. | 2 | 10 | 18,500 | $60 | $1.1M |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 1 | 20 | 1,920 | $110 | $858.9K |
| 96374 | The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition. | 1 | 10 | 5,800 | $90 | $519.4K |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 1 | 10 | 3,680 | $120 | $424.3K |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 2 | 10 | 19,470 | $20 | $321.5K |
| 77063 | The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis… | 1 | 10 | 160 | $290 | $286.3K |
| 77067 | The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software… | 2 | 10 | 2,780 | $80 | $221.3K |
| 99218 | N/A | 1 | 10 | 640 | $290 | $188.2K |
| 71046 | In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and… | 1 | 10 | 3,310 | $60 | $177.3K |
Showing 1–10 of 166
Other providers in the same ZIP code as Governor Juan F. Luis Hospital & Medical Center, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Caribbean Hematology And Oncology Center LLC | VI | Hematology & Oncology Physician | $0 | $102.1K |
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