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.

Neurology & Headache Clinic PLLC (NPI 1336185164)

Neurology & Headache Clinic PLLC is a neurology physician provider located in Charleston, West Virginia. This profile covers 0 Medicare and 43 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	Neurology & Headache Clinic PLLC
Address	3100 Maccorkle Ave Se
City	Charleston
State	WV
ZIP	25304
Taxonomy	Neurology Physician
NPI Enumerated	June 21, 2006

Payer Source	Total Paid
Medicaid	$3.8M
Medicare	$0

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

43 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…	25,880	$50	$1.3M
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	4,230	$110	$448.1K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	2,590	$150	$374.8K
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…	4,330	$80	$342.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5,530	$50	$281.8K
95911	In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	1,180	$140	$165.7K
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…	4,400	$40	$154.1K
95913	In this procedure, the provider performs 13 or more nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	680	$190	$128.3K
G8783	Normal blood pressure reading documented, follow-up not required	6,750	$10	$81K
95910	In this procedure, the provider performs seven or eight nerve conduction studies, a diagnostic test to evaluate the function, especially the electrical conduction ability of the motor and sensory…	740	$110	$80.6K

Showing 1–10 of 43

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

Neurology & Headache Clinic PLLC — 12 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

43 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…	364	1,270	1,240	$30	$245K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	40	190	660	$40	$226.4K
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…	31	1,030	890	$50	$221K
95816	Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure the provider performs the EEG…	2	10	250	$140	$158.6K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	2	30	400	$90	$111.5K
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…	16	340	140	$90	$97.5K
95911	In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	2	10	70	$140	$82.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	39	130	200	$70	$82.4K
95913	In this procedure, the provider performs 13 or more nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	2	10	300	$160	$78.8K
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…	324	440	110	$60	$57.2K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthteam Critical Care Transport LLC	WV	Land Ambulance	$2.5M	$19.8M
Cabin Creek Health Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.2M
Holistic, Inc	WV	Family Medicine Physician	$0	$8M
Valley Health Systems, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$7.1M
Imad Shammaa	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.2M
Summit Bhc West Virginia LLC	WV	Substance Use Disorder Rehabilitation Hospital Unit	$0	$5.1M
General Anesthesia Services Inc	WV	Anesthesiology Physician	$0	$4.3M
Bioscrip Infusion Services, LLC	WV	Home Infusion Therapy Pharmacy	$0	$3.3M
Don E. Skaff, Dds, Inc.	WV	Pediatric Dentistry	$0	$2M
Summit Bhc West Virginia, LLC	WV	Psychiatry Physician	$0	$1.8M

Neurology & Headache Clinic PLLC — Billing Profile & Reimbursement Data

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Neurology & Headache Clinic PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Darshankumar Dave	WV	Neurology Physician	$606.6K	$0
Alexius Ramsey	WV	Physician Assistant	$8.7K	$0