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.

Braxton County Memorial Hospital (NPI 1285025825)

Braxton County Memorial Hospital is a critical access hospital provider located in Gassaway, West Virginia. This profile covers 0 Medicare and 112 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	Braxton County Memorial Hospital
Address	100 Hoylman Dr
City	Gassaway
State	WV
ZIP	26624
Taxonomy	Critical Access Hospital
NPI Enumerated	February 17, 2015

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

112 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.	3,870	$70	$282.7K
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.	5,540	$40	$227.1K
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.	1,020	$150	$148.5K
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.	3,690	$40	$140.2K
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.	6,710	$20	$107.4K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	2,640	$40	$95.1K
93005	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…	4,180	$20	$83.5K
84484	The lab analyst performs the technical lab test typically using serum, plasma, or whole blood to quantitate troponin. Troponin is a protein labs commonly measure to verify a myocardial infarction and…	3,880	$20	$81.6K
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…	7,440	$10	$74.4K
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.	260	$260	$67.6K

Showing 1–10 of 112

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

Braxton County Memorial Hospital — 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

112 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.	52	130	2,090	$210	$1.5M
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.	60	170	3,350	$120	$1.1M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	26	30	180	$40	$773.3K
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.	82	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.	66	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.	92	110	2,080	$50	$537.1K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	24	30	300	$240	$420K
G0378	Hospital observation service, per hour	33	50	940	$140	$363K
G0481	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…	21	20	690	$80	$346.6K
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.	46	110	5,530	$20	$344.8K

Showing 1–10 of 112

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Braxton County Memorial Hospital	WV	Critical Access Hospital	$0	$4.9M
Braxton County Memorial Hospital	WV	Rural Health Clinic/Center	$0	$2.8M
Brian Richardson	WV	Emergency Medicine Physician	$80K	$0
Brandon Wilson	WV	General Practice Physician	$62.3K	$6.4K
Dennis Laird	CT	Emergency Medicine Physician	$68.3K	$0
Yaoxian Ding	RI	Anatomic Pathology & Clinical Pathology Physician	$36.9K	$22.7K
Howard Lafferty	WV	Family Medicine Physician	$57.2K	$0
Matthew Szarko	WV	Anatomic Pathology & Clinical Pathology Physician	$55K	$0
Ronald Pearson	GA	Surgery Physician	$54.9K	$0
Gerald Wedemeyer	WV	Clinical Pathology/Laboratory Medicine Physician	$53.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greenbrier Emergency Services, Inc.	WV	Emergency Medicine Physician	$0	$18.1M
Chad Lancaster	WV	General Practice Dentistry	$0	$1.2M

Braxton County Memorial Hospital — Billing Profile & Reimbursement Data

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Braxton County Memorial Hospital — 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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