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.

Potomac Valley Hospital Of W Va , Inc (NPI 1316054919)

Potomac Valley Hospital Of W Va , Inc is a emergency medicine physician provider located in Keyser, 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	Potomac Valley Hospital Of W Va , Inc
Address	100 Pin Oak Lane
City	Keyser
State	WV
ZIP	26726
Taxonomy	Emergency Medicine Physician
NPI Enumerated	August 23, 2006

Payer Source	Total Paid
Medicaid	$2.3M
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
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.	7,800	$80	$600.8K
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.	9,570	$50	$478.3K
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…	5,640	$80	$428.9K
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…	7,530	$50	$383.9K
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…	1,770	$60	$106.1K
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…	1,040	$100	$100.5K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	2,350	$30	$70.5K
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…	300	$100	$29.4K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	210	$120	$25.7K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	380	$70	$25.3K

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

Potomac Valley Hospital Of W Va , Inc — 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
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.	115	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.	47	170	3,350	$120	$1.1M
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.	42	160	3,690	$80	$714.8K
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…	255	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…	166	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…	211	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…	95	100	550	$80	$164.8K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	32	100	1,200	$50	$135.9K
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…	51	340	140	$90	$97.5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	38	100	120	$100	$69.6K

Showing 1–10 of 28

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Potomac Valley Hospital Of W Va , Inc	WV	Critical Access Hospital	$0	$11M
Potomac Valley Hospital Of W Va , Inc	WV	Rural Health Clinic/Center	$0	$855K
Rabie Zalzal	WV	Internal Medicine Physician	$189.1K	$17.9K
Harshad Bokil	WV	Internal Medicine Physician	$146.5K	$58.3K
Vishal Gupta	WV	Gastroenterology Physician	$108.1K	$0
Brian Richardson	WV	Emergency Medicine Physician	$80K	$0
Lakshmi Muthukumar	WI	Cardiovascular Disease Physician	$77.8K	$0
Charles Bess	WV	Family Medicine Physician	$77.6K	$0
Joseph Nnadike	DC	Emergency Medicine Physician	$70.2K	$0
Brandon Wilson	WV	General Practice Physician	$62.3K	$6.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sycamore Run, LLC	WV	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$13.5M
Burlington United Methodist Family Services, Inc.	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$8.6M
Burlington United Methodist Family Services, Inc.	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$7.4M
Aging & Family Services Of Mineral County, Inc	WV	In Home Supportive Care Agency	$0	$6.6M
Recovery Care LLC	WV	Specialist	$0	$3.5M
Developmental Center & Workshop, Inc.	WV	Developmentally Disabled Services Day Training Agency	$0	$2.7M
Aging & Family Services Of Mineral County, Inc	WV	In Home Supportive Care Agency	$0	$2.6M
Aging And Family Services Of Mineral County, Inc.	WV	Community/Behavioral Health Agency	$0	$1.6M
Recovery Care LLC	WV	Community/Behavioral Health Agency	$0	$1.3M
Heather Rosen-turley	WV	Family Medicine Physician	$41.8K	$635.7K

Potomac Valley Hospital Of W Va , Inc — Billing Profile & Reimbursement Data

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Potomac Valley Hospital Of W Va , Inc — 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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