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.

Princeton Community Hospital Assn Inc. (NPI 1093917643)

Princeton Community Hospital Assn Inc. is a urology physician provider located in Princeton, West Virginia. This profile covers 0 Medicare and 177 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Princeton Community Hospital Assn Inc.
Address	118 12th Street
City	Princeton
State	WV
ZIP	24740
Taxonomy	Urology Physician
NPI Enumerated	June 5, 2007

Payer Source	Total Paid
Medicaid	$15.4M
Medicare	$0

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

177 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	30,880	$80	$2.3M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	52,580	$40	$2.1M
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.	26,040	$50	$1.2M
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…	21,190	$60	$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…	22,360	$50	$1M
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.	8,350	$100	$867.9K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7,920	$110	$839.5K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	24,180	$30	$604.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	8,550	$60	$521.5K
99204	The provider sees a new 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 provider…	4,530	$90	$416.3K

Showing 1–10 of 177

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

Princeton Community Hospital Assn Inc. — 10 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

177 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.	27	130	2,090	$210	$1.5M
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.	17	170	3,350	$120	$1.1M
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.	17	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.	33	80	950	$140	$559.5K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	29	80	1,410	$120	$332.8K
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.	27	90	1,380	$60	$273.2K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	10	20	1,150	$130	$261.7K
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…	99	1,270	1,240	$30	$245K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	4	190	660	$40	$226.4K
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…	37	1,030	890	$50	$221K

Showing 1–10 of 177

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Princeton Community Hospital Assn., Inc.	WV	General Acute Care Hospital	$0	$41M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
Joseph Baisden	WV	Radiation Oncology Physician	$1.9M	$0
Alex Pallas	IL	Diagnostic Radiology Physician	$221K	$32.2K
Vishnu Patel	WV	Pulmonary Disease Physician	$245.4K	$0
Robert Ortega	IL	Diagnostic Radiology Physician	$167.2K	$74K
James Perry	WV	Critical Care Medicine (Internal Medicine) Physician	$237.8K	$0
Walid Alami	VA	Interventional Cardiology Physician	$222K	$0
Anuradha Tunuguntla	PA	Interventional Cardiology Physician	$218.5K	$0
Hrak Chemchirian	IN	Clinical Cardiac Electrophysiology Physician	$210.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voca Corporation Of West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$178.3M
Southern Highlands Community Mental Health Center, Inc.	WV	Community/Behavioral Health Agency	$0	$44.2M
Southern Highlands Community Mental Health Center, Inc.	WV	Counselor	$0	$22M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$12.1M
Princeton Rescue Squad Inc	WV	Land Ambulance	$1.1M	$10.4M
Foot And Ankle Clinic Of The Virginias Inc	WV	Podiatrist	$0	$5.5M
Bradley Hoffman	WV	Foot & Ankle Surgery Podiatrist	$4.9M	$0
Beautiful Minds Counseling Center	WV	Mental Health Counselor	$0	$4.1M
Bluefield Gastroenterology PLLC	WV	Specialist	$0	$4M
Inas Al-attar	WV	Pediatric Infectious Diseases Physician	$0	$3.9M

Princeton Community Hospital Assn Inc. — Billing Profile & Reimbursement Data

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Princeton Community Hospital Assn Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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