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 Kentucky for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

James West (NPI 1144206392)

Field	Value
Entity Type	Individual
Organization	James West
Address	602 Knox St
City	Barbourville
State	KY
ZIP	40906
Taxonomy	Family Medicine Physician
NPI Enumerated	December 20, 2005

Payer Source	Total Paid
Medicare	$42.4K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	210	$60	$12.2K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	140	$90	$12.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	130	$60	$7.7K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	100	$30	$3.1K
99235	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	20	$100	$1.8K
99315	The provider sees a patient for nursing facility discharge management requiring 30 minutes or less.	30	$60	$1.7K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	20	$100	$1.5K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	40	$40	$1.4K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	10	$60	$830

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Kentucky Distribution

James West — 1 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. state median

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99232	823	2,860	100	$60	$11.6K
99305	112	140	30	$100	$7.6K
99307	65	160	80	$30	$4.7K
99222	101	2,070	30	$90	$4.5K
99231	443	910	40	$40	$3.1K
99238	34	580	30	$60	$2.7K
99235	4	20	20	$110	$2K
99221	331	470	20	$60	$1.8K
99315	15	50	20	$60	$1.7K

Related Providers

Other providers that share a Tax Identification Number (TIN) with James West, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arh Mary Breckinridge Health Services, Inc.	KY	Critical Access Hospital	$0	$33.2M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Arh Mary Breckinridge Health Services, Inc.	KY	Critical Access Hospital	$0	$24.8M
Arh Mary Breckinridge Health Services, Inc.	KY	Critical Access Hospital	$0	$16.2M
Joseph Palumbo	WV	Emergency Medicine Physician	$7.9M	$44.3K
Randy Fanous	CA	Diagnostic Radiology Physician	$339.6K	$911.3K
Bahram Forouzandeh	KY	Gastroenterology Physician	$59K	$925.9K
Matthew Hrastich	MO	Diagnostic Radiology Physician	$134.1K	$399.7K
Kelechi Iwuji	TN	Internal Medicine Physician	$496.4K	$0
Kalpesh Patel	AZ	Diagnostic Radiology Physician	$409.1K	$0

Nearby Providers

Other providers in the same ZIP code as James West, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Barbourville Family Health Center	KY	Rural Health Clinic/Center	$0	$7.6M
Appalachian Restoration Project Inc.	KY	Substance Abuse Rehabilitation Facility	$0	$5M
Family Pride Counseling	KY	Community/Behavioral Health Agency	$0	$3.9M
Family Health Care Associates Of Barbourville Inc	KY	Rural Health Clinic/Center	$0	$3.5M
Knox County Ambulance Service	KY	Land Ambulance	$313.3K	$971.6K
Ashutosh Lohe	KY	Nephrology Physician	$209.2K	$0
Syed Hasni	KY	Nephrology Physician	$188.6K	$0
Kellie Smith	KY	Family Nurse Practitioner	$11.7K	$0
Richard Carter	KY	Family Medicine Physician	$10.1K	$0
Jerry Ward	KY	Clinical Social Worker	$1K	$2.4K

James West — Billing Profile & Reimbursement Data

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James West — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References