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. Mary's Medical Center Inc (NPI 1164492195)

Key Findings

Field	Value
Entity Type	Organization
Organization	St. Mary's Medical Center Inc
Address	2900 First Avenue
City	Huntington
State	WV
ZIP	25702
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 24, 2006

Payer Source	Total Paid
Medicaid	$47.5M
Medicare	$0

This provider has no Medicare billing on file and is effectively a Medicaid-focused provider, with total Medicaid revenue of $47.5M reported. The absence of Medicare activity means analyses of payer mix should treat Medicaid as the dominant, listed payer for billing and revenue exposure.

Revenue is highly concentrated in emergency department evaluation-and-management services: the top three Medicaid codes 99285, 99284, and 99283 together account for 51.0% of the provider's total Medicaid revenue. Individually those codes generate $8.5M (25.6%), $4.8M (14.4%), and $3.6M (11.0%) respectively, indicating the ED is the primary revenue driver.

High ED volume is supported by claim counts and in-state rankings: 99285 shows 31.8K claims and ranks #6 of 132 providers in-state (96th percentile, notably above typical state volume), 99284 has 44.2K claims and ranks #7 of 168 (96th percentile, notably above typical state volume), and 99283 has 49.7K claims and ranks #4 of 163 (98th percentile, notably above typical state volume). These placements characterize the hospital as one of the state’s higher-volume emergency care providers rather than a low-volume community ED.

Clinical support services and high throughput lab work amplify the acute-care profile: 80053 (CMP) appears with 111.8K claims and $1M revenue and is described as an “extreme outlier, far above typical state volume” (rank #3 of 111, 98th percentile), while 85025 (CBC) shows 106.6K claims and $746.2K revenue (rank #5 of 138, 97th percentile). This combination of very high lab volumes plus ED volumes suggests sustained inpatient and emergency throughput requiring substantial laboratory capacity.

Imaging and procedural capabilities supplement the ED-centric mix: CT abdomen/pelvis with contrast 74177 contributes $2.1M (10.3K claims, rank #7 of 76, 92th percentile) and head CT 70450 contributes $1.3M (10.6K claims, rank #8 of 90, 92th percentile), while coronary imaging supervision 93458 generates $693.1K (518 claims, rank #7 of 25, 75th percentile). These codes indicate on-site cross-sectional imaging and cardiac catheterization imaging capacity consistent with a general acute care hospital.

High utilization of toxicology and infectious disease testing supports an ED and inpatient diagnostic focus: definitive drug testing G0480 has 20.2K claims and $1.6M revenue (rank #7 of 54, 89th percentile), presumptive drug testing 80307 has 22K claims and $1M revenue (rank #11 of 106, 90th percentile), and SARS-CoV-2 testing U0003 shows 8.4K claims and $538.6K revenue (rank #4 of 39, 92th percentile). These testing volumes point to robust lab services that support acute presentations, behavioral health intake, or toxicology screening associated with emergency care.

Several lab codes are statistical outliers statewide: 83735 (magnesium) is listed as an “extreme outlier, far above typical state volume” and ranks #1 of 96, while 80053 (CMP) is also an “extreme outlier” (rank #3 of 111, 98th percentile). The extreme lab outlier status supports interpretation that the hospital processes large numbers of basic metabolic and chemistry panels—consistent with emergency and inpatient monitoring workflows.

Operational tenure is long enough to indicate an established presence: the provider’s NPI was enumerated 2006-01-24 (~20 years ago), which, combined with large Medicaid volumes and high in-state ranks across ED, imaging, and lab codes, suggests a stable acute-care facility with entrenched diagnostic and emergency services in its market.

Medicaid: Complete Services Breakdown

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

370 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	31,810	$270	$8.5M
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.	44,150	$110	$4.8M
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.	49,720	$70	$3.6M
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.	10,260	$210	$2.1M
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	20,250	$80	$1.6M
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.	10,570	$120	$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.	5,070	$220	$1.1M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	22,020	$50	$1M
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.	111,780	$10	$1M
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…	106,590	$10	$746.2K

Showing 1–10 of 370

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. Mary's Medical Center Inc — 11 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

370 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	6	130	2,090	$210	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	10	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.	11	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.	7	170	3,350	$120	$1.1M
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	16	20	70	$20	$832.7K
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.	11	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.	4	160	3,690	$80	$714.8K
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.	7	80	950	$140	$559.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	11	110	2,080	$50	$537.1K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	7	50	800	$70	$504.4K

Showing 1–10 of 370

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ahmed Abdelgaber	WV	Family Medicine Physician	$377.5K	$0
Suresh Kumar	WV	Neurology Physician	$252.3K	$0
Michael Collins	WV	Nephrology Physician	$245.3K	$0
Misty Barebo	WV	Family Nurse Practitioner	$187.1K	$0
Khalid Abozguia	WV	Clinical Cardiac Electrophysiology Physician	$155.6K	$0
Arvinder Bir	WV	Hematology & Oncology Physician	$141.8K	$0
Terrence Triplett	WV	Family Medicine Physician	$134.5K	$0
Russell Snyder	WV	Family Medicine Physician	$131.9K	$0
Damian Silbermins	WV	Hematology & Oncology Physician	$129.8K	$0
Mehrette Maru	WV	Interventional Cardiology Physician	$126.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Huntington Hospitalist Group Inc	WV	Hospitalist Physician	$0	$26M
Allied West Virginia Emergency Physicians PLLC	WV	Emergency Medicine Physician	$0	$8.2M
St. Mary's Medical Management, LLC	WV	Family Medicine Physician	$0	$7.6M
Valley Health Systems Inc	WV	Clinical Medical Laboratory	$299.4K	$7M
St Mary's Hospitalist Services, LLC	WV	Internal Medicine Physician	$0	$2.5M
Wecare Medical, LLC	WV	Oxygen Equipment & Supplies (DME)	$0	$1.9M
Abbe Education And Staffing, LLC	WV	In Home Supportive Care Agency	$0	$1.2M
Robin Arora	WV	Nephrology Physician	$392.5K	$0
Rudy Malayil	WV	Interventional Pain Medicine Physician	$295.1K	$0
Sanjeev Sharma	WV	Radiation Oncology Physician	$269K	$0

St. Mary's Medical Center 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