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.

Oak Hill Clinic Corp (NPI 1336148931)

Oak Hill Clinic Corp is a family medicine physician provider located in Oak Hill, West Virginia. This profile covers 0 Medicare and 56 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	Oak Hill Clinic Corp
Address	320 Jones Ave
City	Oak Hill
State	WV
ZIP	25901
Taxonomy	Family Medicine Physician
NPI Enumerated	July 18, 2005

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.

56 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	11,690	$60	$736.7K
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…	14,280	$50	$642.5K
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…	2,400	$100	$235.1K
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…	3,000	$70	$198.1K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1,320	$110	$149K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	360	$220	$77.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	4,420	$10	$44.2K
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,…	1,230	$30	$40.7K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	360	$110	$39.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	180	$160	$29K

Showing 1–10 of 56

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

Oak Hill Clinic Corp — 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

56 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…	159	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…	77	1,030	890	$50	$221K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	23	70	530	$170	$183.7K
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	7	10	50	$1,300	$146.1K
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…	31	340	140	$90	$97.5K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	28	40	200	$220	$86.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	17	20	60	$610	$84.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	71	330	790	$10	$64.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	13	20	190	$270	$60.3K
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…	24	440	110	$60	$57.2K

Showing 1–10 of 56

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Erik Daniels	WV	Medical Physician Assistant	$135K	$0
Paul Conley	WV	Internal Medicine Physician	$36.4K	$0
Holli Carag	WV	Medical Physician Assistant	$27.7K	$0
Scott Killmer	WV	Surgery Physician	$17.3K	$0
Erika Beckett	WV	Family Medicine Physician	$4.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oak Hill Hospital Corporation	WV	Critical Access Hospital	$0	$18.8M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
Oak Hill Emergency Physicians, LLC	WV	Emergency Medicine Physician	$0	$3.8M
Camc Plateau Medical Center, Inc.	WV	Critical Access Hospital	$0	$3.1M
New River Health Association, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.5M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.2M
Adf Behavioral Health Services, LLC	WV	Community/Behavioral Health Agency	$0	$825.9K
Richard Reece	WV	Internal Medicine Physician	$122.1K	$0
Cassandra Ortiz	WV	Optometrist	$28.2K	$0

Oak Hill Clinic Corp — Billing Profile & Reimbursement Data

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Oak Hill Clinic Corp — 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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