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.

Manchin Clinic South, LLC (NPI 1265605208)

Manchin Clinic South, LLC is a clinic/center provider located in White Hall, West Virginia. This profile covers 0 Medicare and 28 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	Manchin Clinic South, LLC
Address	181 Middletown Loop
City	White Hall
State	WV
ZIP	26554
Taxonomy	Clinic/Center
NPI Enumerated	April 10, 2008

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

28 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…	16,390	$50	$819.3K
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…	2,990	$20	$47.9K
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,…	1,430	$30	$40K
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…	2,140	$20	$34.2K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	590	$30	$18.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	550	$30	$18.5K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	560	$20	$13.4K
J0696	Injection, ceftriaxone sodium, per 250 mg	630	$20	$12.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	300	$30	$8K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	200	$40	$7.7K

Showing 1–10 of 28

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

Manchin Clinic South, LLC — 0 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

28 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…	140	1,270	1,240	$30	$245K
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…	79	140	3,080	$20	$243.1K
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…	929	1,030	890	$50	$221K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	295	310	740	$80	$178.2K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	86	100	550	$80	$164.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	91	140	1,090	$20	$104.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	190	330	790	$10	$64.1K
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…	396	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,…	130	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…	51	310	490	$20	$42K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monongahela Valley Association Of Health Centers, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$16.6M
Alecto Healthcare Services Fairmont LLC	WV	General Acute Care Hospital	$0	$11.7M
Radiological Physician Associates Inc	WV	Diagnostic Radiology Physician	$0	$11.1M
Bbc Rehab, Pc,inc	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$10.5M
Bioscrip Infusion Services, LLC	WV	Home Infusion Therapy Pharmacy	$0	$8.8M
Marion County Rescue Squad Inc	WV	Land Ambulance	$833K	$7.6M
Family Service Of Marion & Harrison Counties Inc	WV	Community/Behavioral Health Agency	$0	$5.5M
Essential Needs Homecare	WV	In Home Supportive Care Agency	$0	$4.7M
Yale Academy LLC	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.8M
Youth Academy, LLC	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.8M

Manchin Clinic South, LLC — Billing Profile & Reimbursement Data

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Manchin Clinic South, LLC — 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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