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.

West Virginia Health Right, Inc. (NPI 1124453964)

West Virginia Health Right, Inc. is a health service clinic/center provider located in Charleston, West Virginia. This profile covers 0 Medicare and 39 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	West Virginia Health Right, Inc.
Address	1520 Washington St. E.
City	Charleston
State	WV
ZIP	25311
Taxonomy	Health Service Clinic/Center
NPI Enumerated	September 12, 2013

Payer Source	Total Paid
Medicaid	$2.7M
Medicare	$0

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	14,610	$50	$774.1K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	15,100	$50	$709.7K
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…	8,360	$80	$626.7K
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,…	2,490	$40	$87.1K
99203	The provider sees a new 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 provider…	990	$70	$67K
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…	680	$100	$66.3K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	950	$70	$63.9K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,050	$50	$51.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	480	$100	$48.3K
D0140	Limited oral evaluation – problem focused	2,880	$20	$43.1K

Showing 1–10 of 39

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

West Virginia Health Right, Inc. — 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

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	6	30	1,020	$50	$438.2K
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…	153	1,270	1,240	$30	$245K
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…	118	1,030	890	$50	$221K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	183	310	740	$80	$178.2K
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…	64	340	140	$90	$97.5K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	58	110	330	$60	$90.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	64	330	790	$10	$64.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	114	190	110	$70	$63.4K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	62	210	280	$40	$59.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	76	200	490	$30	$57.7K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charleston Treatment Center, LLC	WV	Methadone Clinic	$234.5K	$16.8M
Associated Radiologists, Inc.	WV	Diagnostic Radiology Physician	$0	$8M
Charleston Treatment Center, LLC.	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$3.1M
Charleston Treatment Center, LLC	WV	Methadone Clinic	$0	$2.6M
Ashley Patnoe	WV	Pediatric Dentistry	$0	$2.2M
Carrie Frame	WV	Foot & Ankle Surgery Podiatrist	$1.7M	$0
Daymark Inc.	WV	Mental Illness Community Based Residential Treatment Facility	$0	$1.5M
Capital City Pediatrics PLLC	WV	Pediatrics Physician	$0	$762.4K
Greenbrier Vision Center Inc	WV	Optometrist	$0	$761.1K
Alison Poole	WV	Physician Assistant	$584.9K	$0

West Virginia Health Right, Inc. — Billing Profile & Reimbursement Data

Sign up for West Virginia Health Right, Inc. — Billing Profile & Reimbursement Data policy alerts

West Virginia Health Right, Inc. — Billing Profile & Reimbursement Data

Sign up for West Virginia Health Right, Inc. — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References