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.

Boone Memorial Hospital, Inc (NPI 1124617535)

Field	Value
Entity Type	Organization
Organization	Boone Memorial Hospital, Inc
Address	300 4th Street
City	Danville
State	WV
ZIP	25053
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	January 12, 2021

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	11,020	$140	$1.6M
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…	8,660	$1	$8.7K
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,…	40	$1	$70
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	10	$0	$0
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	170	$0	$0
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	60	$0	$0
90656	This code represents a preservative–free trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	20	$0	$0
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	20	$0	$0
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…	30	$0	$0
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…	1,300	$0	$0

Showing 1–10 of 11

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

Boone Memorial Hospital, Inc — 0 of 3 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	134	390	4,610	$130	$2.2M
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…	241	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…	437	1,030	890	$50	$221K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	130	140	550	$50	$67.2K
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…	357	440	110	$60	$57.2K
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,…	457	540	320	$20	$43.2K
11102	The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.	13	10	360	$40	$33.3K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	156	200	360	$20	$26K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	231	430	200	$10	$18.3K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	36	40	50	$20	$3.6K

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with Boone Memorial Hospital, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boone Memorial Hospital, Inc	WV	Critical Access Hospital	$0	$31.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Boone Memorial Hospital, Inc	WV	Rural Health Clinic/Center	$0	$11M
Boone Memorial Hospital, Inc	WV	Rural Health Clinic/Center	$0	$4.1M
Boone Memorial Hospital, Inc	WV	Multi-Specialty Clinic/Center	$0	$1.6M
Boone Memorial Hospital, Inc	WV	Psychiatry Physician	$0	$873.5K
Matthew Hrastich	MO	Diagnostic Radiology Physician	$134.1K	$399.7K
Kalpesh Patel	AZ	Diagnostic Radiology Physician	$409.1K	$0
Mohamad Haffar	WV	Gastroenterology Physician	$274.4K	$0
Crysela Smith	TX	Diagnostic Radiology Physician	$249.7K	$0

Nearby Providers

Other providers in the same ZIP code as Boone Memorial Hospital, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Boone County Community Organization	WV	Nursing Care Agency	$0	$2.3M
Boone County Community Organization	WV	In Home Supportive Care Agency	$0	$1.9M

Boone Memorial Hospital, Inc — Billing Profile & Reimbursement Data

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Boone Memorial Hospital, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References