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.

St Josephs Hospital Of Buckhannon Inc (NPI 1124005061)

Field	Value
Entity Type	Organization
Organization	St Josephs Hospital Of Buckhannon Inc
Address	1 Amalia Dr
City	Buckhannon
State	WV
ZIP	26201
Taxonomy	Critical Access Hospital
NPI Enumerated	December 30, 2005

Payer Source	Total Paid
Medicaid	$41.8M
Medicare	$0

Key Findings

This provider is effectively single‑payer in the available data: there is no Medicare billing on file and its entire reported lifecycle payment volume in the dataset is $41.8M in Medicaid revenue, indicating operational reliance on Medicaid payers for billed services. The NPI was enumerated on 2005-12-30 (~21 years ago), so the provider has been an established submitter in the claims system for two decades.

Revenue concentration is high at the line-item level: the precomputed top three Medicaid codes account for 33.9% of total Medicaid revenue. Those top three codes are 99283 ($3.7M revenue, 13.8% of total Medicaid revenue), 99284 ($3.6M, 13.5%), and 85025 ($1.8M, 6.6%), which together point to a handful of ED and lab services driving a third of Medicaid dollars.

The code mix shows an emergency-department–centered operating profile. High-volume ED evaluation & management codes 99283 (24K claims, $155 avg paid/claim, $3.7M), 99284 (21.6K claims, $168 avg paid/claim, $3.6M) and 99285 ($1.3M, 4.7%) plus observation service G0378 ($400.1K, 1.5%) indicate the hospital functions as a local acute care access point where ED visits and short observation stays are primary revenue drivers.

Laboratory testing and point-of-care diagnostics are a second major service line supporting Medicaid revenue. High counts and revenues for 85025 (57.5K claims, $31 avg, $1.8M), 80053 (54.8K claims, $28 avg, $1.5M), 36415 (54.3K claims, $10 avg, $543.5K) and multiplex respiratory testing 87637 (9K claims, $152 avg, $1.4M) show routine inpatient/outpatient lab throughput is a material component of the business model. Notably, 87637 is described as "notably above typical" state volume and 83036 (A1C) is an "extreme outlier," signaling unusually high chronic disease monitoring and infectious-respiratory testing activity relative to peers.

State competitive standing is mixed: for core ED codes the provider sits in the upper percentiles but is described as typical in state context—99283 ranks #18 of 163 (90th percentile; typical, unremarkable volume) and 99284 ranks #23 of 168 (87th percentile; typical, unremarkable volume). These placements suggest a solid emergency volume versus peers but not a statewide dominant ED market share.

For certain diagnostics the provider is a leading state performer: 87637 (multiplex SARS–CoV‑2/influenza/RSV testing) ranks #3 of 32 in-state (94th percentile; notably above typical state volume), 83036 (A1C) ranks #4 of 141 (98th percentile; extreme outlier), and 80061 (lipid panel) ranks #3 of 99 (98th percentile; notably above typical state volume). These ranks indicate this facility is among the highest-volume performers in West Virginia for multiple lab services.

Imaging and cardiorespiratory diagnostics contribute meaningfully to Medicaid revenue and imply on-site acute diagnostic capability: 74177 CT abdomen/pelvis with contrast ($1.7M, 6.4%), 70450 CT head without contrast ($1.7M, 6.3%), and 93306 echocardiography ($446K, 1.7%) are all in the top-25 Medicaid codes, supporting that the hospital provides substantial emergency imaging and cardiac evaluation capacity to its community.

Operational implications for payers and network planning: given the hospital’s Critical Access Hospital taxonomy and the heavy Medicaid dollar concentration in ED E/M, routine lab work, and imaging, payers should expect steady outpatient and ED utilization patterns rather than large elective inpatient surgical throughput. The mixed profile—strong lab and imaging volumes with high-percentile ranks for specific tests but no Medicare activity—suggests contracting or network decisions should prioritize ED coverage and ambulatory diagnostic access for Medicaid populations in this region.

Medicaid: Complete Services Breakdown

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

307 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	24,010	$160	$3.7M
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.	21,610	$170	$3.6M
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…	57,520	$30	$1.8M
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.	2,260	$760	$1.7M
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.	2,950	$570	$1.7M
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.	54,800	$30	$1.5M
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	9,030	$150	$1.4M
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.	7,870	$160	$1.3M
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.	1,720	$630	$1.1M
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	21,640	$40	$951.9K

Showing 1–10 of 307

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

St Josephs Hospital Of Buckhannon Inc — 4 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

307 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	345	390	4,610	$130	$2.2M
J0178	Injection, aflibercept, 1 mg	5	10	220	$650	$2.1M
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	7	10	230	$40	$1.9M
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.	28	130	2,090	$210	$1.5M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	6	20	270	$20	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	8	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.	8	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.	23	170	3,350	$120	$1.1M
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.	9	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.	18	160	3,690	$80	$714.8K

Showing 1–10 of 307

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Josephs Hospital Of Buckhannon Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs Hospital Of Buckhannon	WV	Internal Medicine Physician	$0	$4.5M
St. Joseph's Hospital Of Buckhannon, Inc.	WV	Rural Health Clinic/Center	$0	$2.2M
St. Joseph's Hospital Of Buckhannon, Inc.	WV	Rural Health Clinic/Center	$0	$1.1M
David Waxman	WV	Adult Reconstructive Orthopaedic Surgery Physician	$163.8K	$0
David Tingler	WV	Cardiovascular Disease Physician	$145.7K	$0
Paul Brager	WV	Hematology & Oncology Physician	$129.5K	$0
David Faber	WV	Surgery Physician	$123.5K	$0
Brian Mcmillan	WV	Ophthalmology Physician	$113.6K	$0
Thomas Mauger	WV	Ophthalmology Physician	$94.8K	$0
Brian Kazienko	WV	Cardiovascular Disease Physician	$86.1K	$7K

Nearby Providers

Other providers in the same ZIP code as St Josephs Hospital Of Buckhannon Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central West Virginia Aging Services Inc (hmkr)	WV	Home Health Agency	$0	$61.8M
Central West Virginia Aging Services, Inc. (cm)	WV	Case Management Agency	$0	$8.6M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$6.3M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$5.1M
Drs Martino & Wilson, PLLC	WV	General Practice Dentistry	$0	$4.1M
Upshur County Emergency Medical Services Inc	WV	Land Ambulance	$336.2K	$3.6M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$3.5M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$3M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$867.3K
Allison Bardes	WV	Ophthalmology Physician	$172.5K	$0

St Josephs Hospital Of Buckhannon Inc — Billing Profile & Reimbursement Data

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St Josephs Hospital Of Buckhannon 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