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    OpenPayerNPI Medicare & MedicaidSt. Joseph's Hospital Of Buckhannon, Inc.
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    St. Joseph's Hospital Of Buckhannon, Inc. — Billing Profile & Reimbursement Data

    NPI 1528607314 · Buckhannon, WV · Rural Health Clinic/Center

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    St. Joseph's Hospital Of Buckhannon, Inc. is a rural health clinic/center provider located in Buckhannon, West Virginia. This profile covers 0 Medicare and 26 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationSt. Joseph's Hospital Of Buckhannon, Inc.
    Address21 Auction Ln
    CityBuckhannon
    StateWV
    ZIP26201
    TaxonomyRural Health Clinic/Center
    NPI EnumeratedDecember 27, 2019

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$1.1M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    26 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive9,400$110$1.1M
    99213The 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…2,010$1$4K
    87804The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.20$0$0
    87807The lab analyst performs the technical lab test to analyze for the presence of respiratory syncytial virus (RSV) in a specimen by immunoassay using direct optical, meaning visual, observation.40$0$0
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.1,480$0$0
    90472This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.1,000$0$0
    90474In this procedure, the provider administers an additional live attenuated vaccine either via oral or intranasal route after the administration of the first vaccine.80$0$0
    90633This code represents a vaccine product administered into a muscle to protect against hepatitis A, a liver infection. This code is specific to a pediatric/adolescent dosage with a two–dose schedule.40$0$0
    90648This code represents a Haemophilus influenzae type b (Hib) vaccine product administered into the muscle to protect against Hib disease. This formulation uses a PRP–T conjugate and follows a four–dose…390$0$0
    90670This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…310$0$0

    Showing 1–10 of 26

    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.

    Full comparison — all codes billed, vs. West Virginia median

    26 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive1483904,610$130$2.2M
    99213The 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…5401,2701,240$30$245K
    99214The 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…4041,030890$50$221K
    99392Preventive 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…65150520$50$76.2K
    99391Preventive 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…48140550$50$67.2K
    99212The 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,…495540320$20$43.2K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.99190220$50$42.7K
    99309The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…5080310$10$37.1K
    96110The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…59120440$10$28.2K
    90472This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.64200360$20$26K

    Showing 1–10 of 26

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with St. Joseph's Hospital Of Buckhannon, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    St Josephs Hospital Of Buckhannon IncWVCritical Access Hospital$0$41.8M
    St Josephs Hospital Of BuckhannonWVInternal Medicine Physician$0$4.5M
    St. Joseph's Hospital Of Buckhannon, Inc.WVRural Health Clinic/Center$0$2.2M
    David WaxmanWVAdult Reconstructive Orthopaedic Surgery Physician$163.8K$0
    David TinglerWVCardiovascular Disease Physician$145.7K$0
    Paul BragerWVHematology & Oncology Physician$129.5K$0
    David FaberWVSurgery Physician$123.5K$0
    Brian McmillanWVOphthalmology Physician$113.6K$0
    Thomas MaugerWVOphthalmology Physician$94.8K$0
    Brian KazienkoWVCardiovascular Disease Physician$86.1K$7K

    Nearby Providers

    Other providers in the same ZIP code as St. Joseph's Hospital Of Buckhannon, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Central West Virginia Aging Services Inc (hmkr)WVHome Health Agency$0$61.8M
    Central West Virginia Aging Services, Inc. (cm)WVCase Management Agency$0$8.6M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$6.3M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$5.1M
    Drs Martino & Wilson, PLLCWVGeneral Practice Dentistry$0$4.1M
    Upshur County Emergency Medical Services IncWVLand Ambulance$336.2K$3.6M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$3.5M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$3M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$867.3K
    Allison BardesWVOphthalmology Physician$172.5K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. West Virginia Providers
    0 of 5 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. West Virginia Distribution
    St. Joseph's Hospital Of Buckhannon, Inc. — 0 of 2 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — West Virginia