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.

Brandon M Lingenfelter Do Phd (NPI 1255788758)

Brandon M Lingenfelter Do Phd is a obstetrics & gynecology physician provider located in Princeton, West Virginia. This profile covers 0 Medicare and 59 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	Brandon M Lingenfelter Do Phd
Address	411 12th Street Ext
City	Princeton
State	WV
ZIP	24740
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	May 16, 2016

Payer Source	Total Paid
Medicaid	$3.9M
Medicare	$0

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

59 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…	18,810	$60	$1.2M
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	6,350	$60	$387.2K
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…	3,930	$70	$282.9K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	370	$740	$270.5K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	2,590	$80	$196.9K
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…	1,710	$100	$162.7K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	3,580	$30	$107.3K
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	3,570	$30	$107.2K
59430	For this service, the provider or nonphysician healthcare professional provides care to the patient in the outpatient setting following the delivery. Routine postpartum care can involve one or more…	460	$220	$102.3K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,330	$80	$102.1K

Showing 1–10 of 59

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

Brandon M Lingenfelter Do Phd — 2 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

59 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	5	10	230	$40	$1.9M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	8	20	270	$20	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	11	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.	10	40	820	$30	$1.2M
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	8	20	150	$700	$308.2K
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…	126	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…	217	1,030	890	$50	$221K
88141	The physician analyzes and interprets a cervical or vaginal cytopathology specimen, using any reporting system, such as Bethesda or non–Bethesda. This code is for the professional interpretation by…	6	10	530	$10	$165.5K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	6	10	320	$70	$132.2K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	40	100	2,470	$20	$130K

Showing 1–10 of 59

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voca Corporation Of West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$178.3M
Southern Highlands Community Mental Health Center, Inc.	WV	Community/Behavioral Health Agency	$0	$44.2M
Princeton Community Hospital Assn., Inc.	WV	General Acute Care Hospital	$0	$41M
Southern Highlands Community Mental Health Center, Inc.	WV	Counselor	$0	$22M
Princeton Community Hospital Assn Inc.	WV	Urology Physician	$0	$15.4M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$12.1M
Princeton Rescue Squad Inc	WV	Land Ambulance	$1.1M	$10.4M
Foot And Ankle Clinic Of The Virginias Inc	WV	Podiatrist	$0	$5.5M
Bradley Hoffman	WV	Foot & Ankle Surgery Podiatrist	$4.9M	$0
Beautiful Minds Counseling Center	WV	Mental Health Counselor	$0	$4.1M

Brandon M Lingenfelter Do Phd — Billing Profile & Reimbursement Data

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Brandon M Lingenfelter Do Phd — 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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