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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to 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. 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.

Western Virginia Regional Emergency Physicians, LLC (NPI 1386183028)

Field	Value
Entity Type	Organization
Organization	Western Virginia Regional Emergency Physicians, LLC
Address	100 15th St Nw
City	Norton
State	VA
ZIP	24273
Taxonomy	Emergency Medicine Physician
NPI Enumerated	February 14, 2017

Payer Source	Total Paid
Medicaid	$15.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 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.	86,330	$90	$7.7M
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.	105,510	$60	$6.4M
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.	48,360	$30	$1.6M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1,340	$90	$121.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	35,750	$1	$107.3K
99281	The provider sees a patient for the lowest level emergency department visit.	150	$10	$1.9K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	30	$30	$990
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	30	$30	$890
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	10	$0	$0
M1208	Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety	30	$0	$0

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Western Virginia Regional Emergency Physicians, LLC — 3 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

10 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.	9	340	160	$130	$1.3M
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.	36	630	90	$140	$1.1M
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.	7	620	70	$120	$1M
99281	The provider sees a patient for the lowest level emergency department visit.	71	100	610	$160	$242.1K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	35	130	440	$120	$197K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	251	290	360	$50	$160.1K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	57	80	170	$190	$66.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	14	280	190	$1	$32.3K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	298	310	220	$1	$1.1K
M1208	Patient is not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety	5	10	110	$0	$0

Related Providers

Other providers that share a Tax Identification Number (TIN) with Western Virginia Regional Emergency Physicians, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Courtney Pendergraft	TN	Family Nurse Practitioner	$2.8M	$0
Alex Hamidi	VA	Emergency Medicine Physician	$131K	$0
Douglas Carroll	TN	Medical Physician Assistant	$103.8K	$0
Mary Duran	NC	Family Medicine Physician	$51.8K	$0

Nearby Providers

Other providers in the same ZIP code as Western Virginia Regional Emergency Physicians, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Planning District One Behavioral Health Services	VA	Community/Behavioral Health Agency	$0	$28M
Norton Community Hospital, Inc	VA	General Acute Care Hospital	$0	$8.2M
Norton Community Physician Services LLC	VA	Internal Medicine Physician	$0	$6.4M
Med-trans Corporation	VA	Air Ambulance	$255.4K	$488.3K
Orson Go	VA	Cardiovascular Disease Physician	$557.2K	$0
Gary Hubbard	VA	Optometrist	$32.5K	$256.9K
Shipeng Yu	VA	Cardiovascular Disease Physician	$116.9K	$0
April Wallace	VA	Family Nurse Practitioner	$65.2K	$0
Natasha Stanley	VA	Family Nurse Practitioner	$41.8K	$0
David Nauss	VA	Anesthesiology Physician	$10.9K	$0

Western Virginia Regional Emergency Physicians, LLC — Billing Profile & Reimbursement Data

Sign up for Western Virginia Regional Emergency Physicians, LLC — Billing Profile & Reimbursement Data policy alerts

Western Virginia Regional Emergency Physicians, LLC — Billing Profile & Reimbursement Data

Sign up for Western Virginia Regional Emergency Physicians, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References