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.

Rainelle Medical Center, Inc. (NPI 1528417946)

Field	Value
Entity Type	Organization
Organization	Rainelle Medical Center, Inc.
Address	390 Industrial Park
City	Maxwelton
State	WV
ZIP	24957
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 7, 2016

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	10,450	$160	$1.7M
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…	3,590	$10	$21.5K
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,…	2,120	$1	$6.4K
D9999	N/A	120	$50	$5.8K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	140	$30	$4.4K
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…	990	$1	$4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	810	$1	$2.4K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	150	$10	$760
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	10	$60	$730
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	30	$20	$400

Showing 1–10 of 20

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

Rainelle Medical Center, Inc. — 0 of 13 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	139	390	4,610	$130	$2.2M
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…	411	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…	501	1,030	890	$50	$221K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	302	310	740	$80	$178.2K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	47	90	170	$60	$72.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	160	330	790	$10	$64.1K
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,…	105	540	320	$20	$43.2K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	257	260	300	$50	$38.5K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	104	140	900	$10	$38.3K
D9999	N/A	16	30	120	$170	$37.3K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rainelle Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rainelle Medical Center Inc	WV	Federally Qualified Health Center (FQHC)	$0	$14.3M
Rainelle Medical Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.5M
Rainelle Medical Center, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.3M
Rainelle Medical Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.2M
Rainelle Medical Center, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.2M
Rainelle Medical Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$798.4K
Heather Ratliff	WV	Nephrology Physician	$87.7K	$0
Gary Ross	WV	Internal Medicine Physician	$49.2K	$0
Christopher Martin	WV	Family Medicine Physician	$13.7K	$0
Hannah Davis	WV	Family Nurse Practitioner	$12.7K	$0

Nearby Providers

Other providers in the same ZIP code as Rainelle Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seneca Health Services Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$38.1M
Seneca Health Services, Inc.	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$14.1M
Seneca Health Services Inc	WV	Community/Behavioral Health Agency	$0	$2.8M

Rainelle Medical Center, Inc. — Billing Profile & Reimbursement Data

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Rainelle Medical Center, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References