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 West Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to West Virginia 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. West Virginia (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.

Preston Memorial Hospital Corporation (NPI 1013950054)

Key Findings

Field	Value
Entity Type	Organization
Organization	Preston Memorial Hospital Corporation
Address	150 Memorial Dr
City	Kingwood
State	WV
ZIP	26537
Taxonomy	Critical Access Hospital
NPI Enumerated	June 14, 2006

Payer Source	Total Paid
Medicaid	$20.2M
Medicare	$0

This provider is effectively single‑payer in the dataset: there is no Medicare billing on file while total Medicaid revenue is $20.2M, so the observable commercial/Medicare footprint is absent or recorded elsewhere in the dataset. Analysts should treat the provider’s Medicare exposure as nil in these records and focus on Medicaid-driven activity for revenue and service-line insights.

Revenue concentration in Medicaid is focused in emergency department evaluation-and-management services: the top three Medicaid codes (99285, 99284, 99283) together account for 36.1% of this provider’s total Medicaid revenue. Individually those codes generate $2.2M (99285, 14.9%), $1.6M (99284, 10.7%), and $1.6M (99283, 10.4%), making ED E/M visits the single largest revenue block on the Medicaid ledger.

The overall code mix points to a full‑service rural hospital with an active emergency department plus on‑site imaging, laboratory, observation, infusion, and outpatient therapy. High‑revenue ED codes (99285/99284/99283) alongside imaging codes 74177 and 70450, lab panels such as 80053, and therapy codes 97110/97140 indicate the facility provides acute care, diagnostic imaging, inpatient or observation services, and rehabilitative outpatient visits.

Competitive standing for core ED codes is middling to typical statewide: 99285 ranks #32 of 132 providers (76th percentile), 99284 ranks #51 of 168 (70th percentile), and 99283 ranks #43 of 163 (74th percentile), each labeled as "typical, unremarkable volume." These ranks suggest Preston Memorial is not a dominant ED billing leader in West Virginia but is a solid, average contributor for high‑acuity and moderate‑acuity ED care.

Ambulatory outpatient volume appears strong relative to peers: 99213 shows 37.4K claims and $672.9K revenue (4.5% of Medicaid revenue) and ranks #58 of 1273 providers (96th percentile). That high percentile for a common outpatient E/M code implies robust primary/specialty clinic throughput or frequent follow‑up visits billed to Medicaid compared with most in‑state peers.

Ancillary services show notable relative volume and diversification: comprehensive metabolic panel 80053 accounts for $1.4M (9.2%), complete blood count 85025 contributes $605.8K (4.1%), and therapeutic exercise 97110 contributes $593.4K (4.0%). Several lab and therapy codes sit at strong percentile positions (for example 87804 at the 91st percentile, 36415 at the 89th percentile, and 97140 at the 86th), indicating above‑typical lab and rehab activity for the state peer set.

Advanced imaging produces meaningful Medicaid revenue with several high‑unit‑price services: 74177 generated $1.2M (7.7%) at an average paid/claim of $1495, 70450 generated $550.1K (3.7%), and 74176 generated $522.3K (3.5%). Those services rank around the middle of in‑state peers (for example 74177 at the 47th percentile and 70450 at the 53rd percentile), which suggests local capacity for CT imaging without clear dominance in statewide volume.

The provider has a long tenure in the NPI file (enumerated 2006-06-14, ~20 years ago) and is classified as a Critical Access Hospital, supporting interpretation of the billing mix as consistent with a rural acute care hub. Combined with the Medicaid‑centric revenue pattern, this tenure and taxonomy reinforce the view of Preston Memorial as an established local safety‑net/acute provider whose Medicaid activity drives observed financials.

Medicaid: Complete Services Breakdown

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

175 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	6,700	$330	$2.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	7,150	$220	$1.6M
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.	9,160	$170	$1.6M
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.	14,900	$90	$1.4M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	770	$1,500	$1.2M
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…	37,390	$20	$672.9K
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…	14,090	$40	$605.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	6,900	$90	$593.4K
80306	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by instrument–assisted direct optical observation, often utilizing immunoassay, to screen for any number of…	2,960	$190	$553.9K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,470	$380	$550.1K

Showing 1–10 of 175

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other West Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. West Virginia Distribution

Preston Memorial Hospital Corporation — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

175 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	32	130	2,090	$210	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	34	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	34	40	820	$30	$1.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	51	170	3,350	$120	$1.1M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	20	30	180	$40	$773.3K
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.	43	160	3,690	$80	$714.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	41	80	950	$140	$559.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	79	110	2,080	$50	$537.1K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	36	50	800	$70	$504.4K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	27	30	300	$240	$420K

Showing 1–10 of 175

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eric Johnson	KY	Diagnostic Radiology Physician	$78.6K	$3.1M
Preston Memorial Hospital Corporation	WV	Emergency Medicine Physician	$0	$2.6M
Concord Hospital, Inc.	NH	Emergency Medicine Physician	$0	$2.5M
City Hospital, Inc.	WV	Internal Medicine Physician	$0	$1.9M
Adnan Alghadban	WV	Neurology Physician	$533K	$0
John Pappas	MD	Vascular & Interventional Radiology Physician	$487.8K	$17.2K
Zaid Abed Al-qudah	WV	Clinical Neurophysiology Physician	$380.4K	$0
James Benjamin	MD	Diagnostic Radiology Physician	$250.1K	$0
Lowell Larew	WV	Medical Physician Assistant	$193.2K	$0
Surendra Pawar	PA	Diagnostic Radiology Physician	$157.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Preston Health Care Services LLC	WV	Family Health Clinical Nurse Specialist	$0	$3M
Kamp Central Ambulance Service, Inc.	WV	Land Ambulance	$280.9K	$1.9M
Preston Urgent Care Family Practice, LLC	WV	Family Nurse Practitioner	$0	$1.7M
Tracy Underwood	WV	Family Nurse Practitioner	$45.2K	$0
Ashley Gardo	WV	Speech-Language Pathologist	$31.6K	$0
Robin Goodwin	WV	Family Nurse Practitioner	$21.6K	$0
Courtney Swisher	WV	Family Nurse Practitioner	$21.3K	$0
County Of Preston Board Of Health	WV	Public Health & General Preventive Medicine Physician	$5.6K	$10.7K
Jamie Richardson	WV	Certified Registered Nurse Anesthetist	$14.7K	$0

Preston Memorial Hospital Corporation — 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