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.

Princeton Community Hospital Assn., Inc. (NPI 1558313213)

Key Findings

Field	Value
Entity Type	Organization
Organization	Princeton Community Hospital Assn., Inc.
Address	122 12th Street Ext
City	Princeton
State	WV
ZIP	24740
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 17, 2006

Payer Source	Total Paid
Medicaid	$41M
Medicare	$0

This provider is effectively single-payer from an active-billing perspective: there is no Medicare billing on file while total Medicaid revenue is $41M, and the NPI has been enumerated since 2006-05-17 (~20 years ago), indicating a long-lived presence in the market but a current dependence on Medicaid as its primary public payer. Analysts should treat Medicaid policy and reimbursement changes as the primary levers affecting this provider's revenue base.

Revenue is highly concentrated in emergency-department E/M services: the precomputed top-three Medicaid codes account for 62.0% of this provider's Medicaid revenue, and those three codes are 99285, 99284, and 99283. This concentration means a majority of the $41M Medicaid book is driven by acute ED visits rather than elective inpatient or specialty procedural lines.

The code-level mix shows the hospital operates as an ED-centered acute-care facility with substantial throughput: 99285 ($7.8M, 23.3K claims, 27.8% of Medicaid revenue), 99284 ($5.5M, 35.5K claims, 19.4%), and 99283 ($4.2M, 42.5K claims, 14.9%) together anchor the revenue profile and reflect consistent, high-volume emergency evaluation and management activity. Those claim counts and revenues point to steady ED demand as the core service line generating fee-for-service Medicaid revenue.

On competitive standing for its ED volumes, the provider is above typical statewide activity for moderate and lower-acuity ED visits: 99284 ranks #10 of 168 providers in-state (95th percentile; notably above typical state volume) and 99283 ranks #7 of 163 (96th percentile; notably above typical state volume), while 99285 is #10 of 132 (93th percentile; typical, unremarkable volume). In short, this hospital is a material ED player in West Virginia, particularly in moderate- and low-acuity emergency visits.

Ancillary and outpatient treatment services are another distinctive strength: 96372 (24.6K claims, $418.5K, 1.5% of revenue) is ranked #1 of 309 providers in-state (100th percentile; extreme outlier) and 36415 (64K claims, $384.3K, 1.4%) ranks #5 of 328 (99th percentile; extreme outlier). These extreme outlier labels signal unusually high volumes of injections and phlebotomy compared with peers, consistent with heavy ED and outpatient procedure throughput that drives downstream lab and medication-administration activity.

The provider also shows elevated in-house laboratory and testing capacity supporting high patient volumes: 85025 CBC (88.1K claims, $792.9K, 2.8% of revenue) ranks #7 of 138 (96th percentile; notably above typical), 80053 CMP (69.8K claims, $628.1K, 2.2%) ranks #8 of 111 (94th percentile; notably above typical), and multiplex respiratory testing 87637 (10.1K claims, $958.4K, 3.4%) ranks #2 of 32 (97th percentile; notably above typical). Together these codes indicate substantial diagnostic throughput and a capacity to perform high volumes of routine and pandemic-related testing.

Imaging and observation services complement the ED focus but are less dominant: 74176 CT abdomen/pelvis without contrast ($487.2K, 1.7% of revenue) ranks #9 of 77 (89th percentile; typical, unremarkable), 70450 CT head ($456.6K, 1.6%) ranks #12 of 90 (88th percentile; typical, unremarkable), and observation G0378 ($326.6K, 1.2%) ranks #9 of 45 (82th percentile; typical, unremarkable). These placements show the hospital provides expected imaging and short-term observation capacity to support its ED volumes but is not an outlier in imaging relative to peers.

Strategic implication for payers and network analysts: because 62.0% of Medicaid revenue is concentrated in three ED E/M codes and the provider posts extreme outlier volumes in injections and phlebotomy, the hospital represents a concentrated source of Medicaid ED and ancillary spend. Payers should account for potential cost exposure stemming from ED utilization trends and test/infusion volumes when negotiating managed care arrangements or designing utilization management focused on emergency care and high-throughput outpatient services.

Medicaid: Complete Services Breakdown

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

392 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.	23,280	$340	$7.8M
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.	35,530	$150	$5.5M
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.	42,550	$100	$4.2M
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	10,090	$100	$958.4K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	12,480	$70	$848.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	88,100	$10	$792.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	69,790	$10	$628.1K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	11,810	$50	$590.4K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	4,970	$100	$487.2K
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.	7,230	$70	$484.1K

Showing 1–10 of 392

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

Princeton Community Hospital Assn., Inc. — 8 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

392 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.	10	130	2,090	$210	$1.5M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	14	20	270	$20	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	21	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	21	40	820	$30	$1.2M
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.	10	170	3,350	$120	$1.1M
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	11	20	70	$20	$832.7K
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.	7	160	3,690	$80	$714.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	21	80	950	$140	$559.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	28	110	2,080	$50	$537.1K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	13	50	800	$70	$504.4K

Showing 1–10 of 392

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Princeton Community Hospital Assn Inc.	WV	Urology Physician	$0	$15.4M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
Joseph Baisden	WV	Radiation Oncology Physician	$1.9M	$0
Alex Pallas	IL	Diagnostic Radiology Physician	$221K	$32.2K
Vishnu Patel	WV	Pulmonary Disease Physician	$245.4K	$0
Robert Ortega	IL	Diagnostic Radiology Physician	$167.2K	$74K
James Perry	WV	Critical Care Medicine (Internal Medicine) Physician	$237.8K	$0
Walid Alami	VA	Interventional Cardiology Physician	$222K	$0
Anuradha Tunuguntla	PA	Interventional Cardiology Physician	$218.5K	$0
Hrak Chemchirian	IN	Clinical Cardiac Electrophysiology Physician	$210.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Voca Corporation Of West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$178.3M
Southern Highlands Community Mental Health Center, Inc.	WV	Community/Behavioral Health Agency	$0	$44.2M
Southern Highlands Community Mental Health Center, Inc.	WV	Counselor	$0	$22M
Bluestone Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$12.1M
Princeton Rescue Squad Inc	WV	Land Ambulance	$1.1M	$10.4M
Foot And Ankle Clinic Of The Virginias Inc	WV	Podiatrist	$0	$5.5M
Bradley Hoffman	WV	Foot & Ankle Surgery Podiatrist	$4.9M	$0
Beautiful Minds Counseling Center	WV	Mental Health Counselor	$0	$4.1M
Bluefield Gastroenterology PLLC	WV	Specialist	$0	$4M
Inas Al-attar	WV	Pediatric Infectious Diseases Physician	$0	$3.9M

Princeton Community Hospital Assn., Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References