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.

Wetzel County Hospital, Inc. (NPI 1518590033)

Wetzel County Hospital, Inc. is a family medicine physician provider located in New Martinsville, West Virginia. This profile covers 0 Medicare and 46 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	Wetzel County Hospital, Inc.
Address	3 E Benjamin Dr
City	New Martinsville
State	WV
ZIP	26155
Taxonomy	Family Medicine Physician
NPI Enumerated	February 13, 2020

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	9,570	$50	$487.8K
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…	6,290	$70	$415.1K
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.	4,420	$80	$353.9K
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.	4,400	$50	$215.7K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,190	$70	$86.9K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,180	$60	$74K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	950	$70	$67.2K
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.	500	$120	$61.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	650	$80	$50.4K
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…	490	$100	$48.4K

Showing 1–10 of 46

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

Wetzel County Hospital, 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

46 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.	97	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.	71	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.	72	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…	223	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…	145	1,030	890	$50	$221K
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.	75	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…	85	340	140	$90	$97.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	50	150	520	$50	$76.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	43	140	550	$50	$67.2K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	153	330	790	$10	$64.1K

Showing 1–10 of 46

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joseph Palumbo	WV	Emergency Medicine Physician	$7.9M	$44.3K
Wetzel County Hospital Association	WV	Rural Acute Care Hospital	$0	$3M
Wetzel County Hospital, Inc.	WV	Rural Acute Care Hospital	$0	$2.5M
Wetzel County Hospital, Inc.	WV	Rural Health Clinic/Center	$0	$911.8K
John Cherian	PA	Cardiovascular Disease Physician	$320.7K	$0
Zaveen Kureishy	WV	Internal Medicine Physician	$295.1K	$0
Guru Gopireddy	WV	Internal Medicine Physician	$121K	$0
Luay Mrad	WV	Interventional Pain Medicine Physician	$104.5K	$0
Ramazan Peker	WV	Anatomic Pathology & Clinical Pathology Physician	$48.7K	$40.7K
Brian Hornsby	WV	Internal Medicine Physician	$88.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valeo Medical, PLLC	WV	Urgent Care Clinic/Center	$0	$5M
Mid Valley Healthcare Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$2.3M
Mid Valley Healthcare Inc	WV	Community/Behavioral Health Agency	$0	$2M
Wetzel County Emergency Ambulance	WV	Land Ambulance	$254.6K	$1.5M
Anissa Anderson	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$1.2M
Jonathan Blum	WV	Internal Medicine Physician	$108.7K	$0
Audra Lemon	WV	Family Nurse Practitioner	$94.7K	$0
Phillip Slampak	WV	Podiatrist	$78.3K	$0
Dakshina Murthy	WV	Cardiovascular Disease Physician	$54.9K	$0
Mona Mohareb	WV	Anesthesiology Physician	$5.4K	$0

Wetzel County Hospital, Inc. — Billing Profile & Reimbursement Data

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Wetzel County Hospital, 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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