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.

Wheeling Hospital Inc (NPI 1104821305)

Key Findings

Field	Value
Entity Type	Organization
Organization	Wheeling Hospital Inc
Address	1 Medical Park
City	Wheeling
State	WV
ZIP	26003
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 15, 2005

Payer Source	Total Paid
Medicaid	$40.1M
Medicare	$0

WHEELING HOSPITAL INC reports no Medicare billing on file and $40.1M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer Medicaid; this concentration means the hospital’s reported financial and utilization profile is driven almost entirely by Medicaid activity rather than a mixed Medicare/Medicaid payer base. Analysts should treat Medicaid reimbursement policy and state network placement as primary drivers of the provider’s revenue risk and growth opportunities.

Revenue concentration is material around a small set of evaluation-and-management codes: the top three Medicaid codes by revenue account for 30.9% of the provider’s total Medicaid revenue, with the largest single code 99284 representing 13.7% ($2.9M) of Medicaid revenue. That degree of concentration signals that a handful of high-volume ambulatory/ED E/M services are key revenue drivers for the organization.

The code mix indicates a combined emergency department and high-volume outpatient clinic operation: 99284, 99285, and 99283 are prominent ED E/M codes while 99213, 99212 and 99214 reflect very high outpatient/office visit volumes. This pattern suggests the hospital functions as both an acute care ED destination and a major provider of routine established-patient visits under Medicaid.

WHEELING shows exceptionally high statewide volume for low-complexity office visits: 99212 ranks #3 of 536 providers (100th percentile, labeled an "extreme outlier") and 99213 ranks #18 of 1273 providers (99th percentile, "notably above typical"). These rankings indicate the hospital is a major volume leader in established-patient outpatient visits within the state, which has implications for primary-care–level capacity and ambulatory throughput.

Emergency department competitive standing is more ordinary: 99284 ranks #20 of 168 providers (89th percentile) and 99285 ranks #33 of 132 providers (76th percentile), both described as typical or unremarkable volumes. In other words, ED visits are a substantial revenue generator (99284 = $2.9M) but the hospital is not an outlier statewide on high-complexity ED volumes.

Ancillary and diagnostic services support the high visit volumes: comprehensive metabolic panel 80053, CBC 85025, phlebotomy 36415, CT abdomen/pelvis 74177, and CT head 70450 appear on the top code list, with 36415 ranking #6 of 328 providers (98th percentile, "extreme outlier") and other labs/imaging in high percentiles. This mix points to an in-house laboratory and imaging footprint with high specimen and test throughput that aligns with both ED and ambulatory encounter volume.

The hospital also bills for infusion/observation and oncology-related services (96365, 96361, G0378, 96413) and for SARS-CoV-2 testing (U0003), indicating capabilities for outpatient infusions, short-term observation care, and pandemic-era diagnostic testing. These services generate nontrivial Medicaid revenue but are described in the dataset as typical state-level volumes, implying capability rather than statewide dominance in these ancillary lines.

WHEELING HOSPITAL’s NPI was enumerated on 2005-06-15 (~21 years ago), reflecting long tenure in the state Medicaid market. Combined with the provider’s Medicaid-centric revenue mix and the concentration in ED and established outpatient E/M codes, this tenure supports the interpretation that the hospital is an established local/regional access point for both acute and routine care for Medicaid beneficiaries.

Medicaid: Complete Services Breakdown

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

462 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.	23,090	$130	$2.9M
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…	68,900	$30	$2.2M
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,…	38,940	$40	$1.5M
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.	6,610	$220	$1.4M
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.	56,390	$20	$1.2M
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.	14,620	$80	$1.2M
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.	4,040	$270	$1.1M
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…	67,090	$20	$1M
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.	12,080	$70	$894.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	12,810	$60	$742.9K

Showing 1–10 of 462

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

Wheeling Hospital Inc — 3 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

462 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.	33	130	2,090	$210	$1.5M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	9	20	270	$20	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	6	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.	6	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.	20	170	3,350	$120	$1.1M
96156	The provider assesses psychological, behavioral, emotional, cognitive, and social factors that affect a patient’s physical health, rather than assessing a specific mental health disorder. There are…	3	10	60	$170	$888.7K
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	3	20	70	$20	$832.7K
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…	22	30	180	$40	$773.3K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	5	20	720	$20	$721.7K
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.	28	160	3,690	$80	$714.8K

Showing 1–10 of 462

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wheeling Hospital Inc	WV	Family Medicine Physician	$0	$8.5M
John Cherian	PA	Cardiovascular Disease Physician	$320.7K	$0
Devender Batra	OH	Cardiovascular Disease Physician	$309.1K	$0
Jondavid Pollock	WV	Radiation Oncology Physician	$254.7K	$0
David Clump	PA	Radiation Oncology Physician	$181.4K	$0
Ghassan Ghorayeb	WV	Ophthalmology Physician	$175.8K	$0
Daniel Wilson	WV	Family Medicine Physician	$160K	$420
Chris Cook	VA	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	$136.7K	$0
Mohammad Akram Kawsara	TX	Interventional Cardiology Physician	$133.8K	$0
Walid Gharib	WV	Cardiovascular Disease Physician	$131.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwood Health Systems Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$67.6M
Northwood Health Systems Inc	WV	Community/Behavioral Health Agency	$0	$52.5M
Lorraine Surgical Supply Of West Virginia Inc.	WV	Durable Medical Equipment & Medical Supplies	$0	$34.6M
Russell Nesbitt Services Inc	WV	Respite Care	$0	$29.5M
Florence Crittenton Programs, Inc.	WV	Mental Health Counselor	$0	$14.4M
Lifeline Addiction Specialists, PLLC	WV	Multi-Specialty Clinic/Center	$0	$7M
Radiology Associates, Inc	WV	Diagnostic Radiology Physician	$0	$6.7M
Serenity Hills Life Center	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.1M
Alecto Healthcare Services Wheeling LLC	WV	General Acute Care Hospital	$0	$6M
Florence Crittenton Services Inc.	WV	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$5.4M

Wheeling Hospital Inc — 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