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.

Community Health Association (NPI 1134417975)

Community Health Association is a clinic/center provider located in Ripley, West Virginia. This profile covers 0 Medicare and 15 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	Community Health Association
Address	200 Academy Drive
City	Ripley
State	WV
ZIP	25271
Taxonomy	Clinic/Center
NPI Enumerated	July 14, 2011

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

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

15 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…	13,550	$60	$745.5K
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…	1,290	$80	$105.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	1,750	$30	$59.5K
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…	490	$60	$31K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	2,000	$10	$28K
87430	The lab analyst performs an assay to evaluate the patient’s sample for antigens to Streptococcus, group A, using an immunoassay method, such as EIA.	1,120	$20	$16.8K
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,…	510	$30	$16.7K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	990	$10	$13.9K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	120	$80	$9.4K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	110	$60	$6.1K

Showing 1–10 of 15

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

Community Health Association — 0 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	171	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…	439	1,030	890	$50	$221K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	28	40	440	$70	$73.2K
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…	108	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,…	229	540	320	$20	$43.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	235	310	490	$20	$42K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	29	190	190	$30	$35.9K
87400	The lab analyst performs the technical lab test to detect antigens of influenza A or B using an immunoassay technique, such as EIA. This analysis will distinguish if a patient has influenza A or B.	9	20	420	$10	$27.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	59	330	320	$20	$24.4K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	66	310	250	$20	$21.7K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Association	WV	Critical Access Hospital	$0	$15.3M
Community Health Association	WV	Rural Health Clinic/Center	$0	$4.4M
David Gnegy	WV	Cardiovascular Disease Physician	$212K	$0
Johnson Tanner	MS	Diagnostic Radiology Physician	$203.1K	$0
Phillip Cox	WV	Critical Care Medicine (Internal Medicine) Physician	$192.1K	$0
Michael Desiderio	NJ	Cardiovascular Disease Physician	$143.8K	$25.9K
Steven Eshenaur	WV	Emergency Medicine Physician	$157.4K	$0
Johnsey Leef	WV	Diagnostic Radiology Physician	$139.1K	$0
Showri Karnam	WV	Interventional Cardiology Physician	$136.1K	$0
Nicholas Moore	CO	Diagnostic Radiology Physician	$123.5K	$100

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wirt County Health Services Association Inc	WV	Federally Qualified Health Center (FQHC)	$0	$3M
Envision Medical Care, LLC	WV	Family Medicine Physician	$0	$2.6M
Jackson County Commission	WV	Ambulance	$324.9K	$2.2M
Byron Black	WV	Oral and Maxillofacial Surgery (Dentist)	$0	$1.3M
Road To Recovery, LLC	WV	Addiction Medicine (Family Medicine) Physician	$0	$1.2M
Perrine & Staunton Family Dentistry PLLC	WV	Dentist	$0	$898.9K
Premier Imaging And Intervention, PLLC	WV	Diagnostic Radiology Physician	$0	$855.4K
Nikola Bicak	WV	Podiatrist	$50.5K	$133.2K
Matthew Thompson	WV	Ophthalmology Physician	$162.9K	$0
Irvin Snyder	WV	Internal Medicine Physician	$98K	$0

Community Health Association — Billing Profile & Reimbursement Data

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Community Health Association — 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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