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.

Hospital Development Co (NPI 1316907322)

Hospital Development Co is a critical access hospital provider located in Spencer, West Virginia. This profile covers 0 Medicare and 146 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	Hospital Development Co
Address	200 Hospital Dr
City	Spencer
State	WV
ZIP	25276
Taxonomy	Critical Access Hospital
NPI Enumerated	March 24, 2006

Payer Source	Total Paid
Medicaid	$14.6M
Medicare	$0

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

146 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.	7,590	$280	$2.1M
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.	6,600	$220	$1.5M
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.	5,150	$160	$839K
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.	11,910	$50	$607.3K
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.	1,410	$410	$575.5K
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.	1,380	$290	$401.9K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	2,750	$140	$390.6K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	5,120	$70	$373.7K
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…	12,660	$30	$354.5K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	6,420	$50	$327.4K

Showing 1–10 of 146

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

Hospital Development Co — 1 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

146 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	357	390	4,610	$130	$2.2M
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.	30	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.	54	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.	62	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.	63	80	950	$140	$559.5K
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…	36	50	800	$70	$504.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	70	140	790	$90	$469.7K
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…	9	30	300	$240	$420K
G0378	Hospital observation service, per hour	32	50	940	$140	$363K
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.	40	110	5,530	$20	$344.8K

Showing 1–10 of 146

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hospital Development Co	WV	Rural Health Clinic/Center	$0	$10.1M
Hospital Development Co	WV	Rural Health Clinic/Center	$0	$7.5M
Hospital Development Co	WV	Rural Health Clinic/Center	$0	$1.1M
Hospital Development Co	WV	Ambulance	$139.8K	$280.1K
Jonathan Hess	OH	Family Medicine Physician	$272.3K	$0
James Perry	WV	Critical Care Medicine (Internal Medicine) Physician	$237.8K	$0
Ryan Waddell	WV	Pulmonary Disease Physician	$209.8K	$0
William Wade	WV	Critical Care Medicine (Internal Medicine) Physician	$200.4K	$0
Kevin Eggleston	WV	Critical Care Medicine (Internal Medicine) Physician	$195.2K	$0
Robby Keith	WV	Critical Care Medicine (Internal Medicine) Physician	$194.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Roane County Family Health Care, Inc.	WV	Family Medicine Physician	$0	$6.5M
Roane County Emergency Squad Inc	WV	Land Ambulance	$150.7K	$1.7M
Sabir Hussain	WV	Hematology & Oncology Physician	$87.2K	$0
Bruce Dye	WV	Sports Physician Chiropractor	$57.6K	$430
Richard Criser	WV	Family Nurse Practitioner	$56.1K	$0
Wal-mart Stores East LP	WV	Community/Retail Pharmacy	$50.2K	$1.8K
Carroll Christiansen	WV	Family Medicine Physician	$6.1K	$0

Hospital Development Co — Billing Profile & Reimbursement Data

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Hospital Development Co — 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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