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.

Mid Ohio Valley Medicine & Pediatrics PLLC (NPI 1558674002)

Mid Ohio Valley Medicine & Pediatrics PLLC is a internal medicine physician provider located in Parkersburg, West Virginia. This profile covers 0 Medicare and 23 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	Mid Ohio Valley Medicine & Pediatrics PLLC
Address	600 18th St
City	Parkersburg
State	WV
ZIP	26101
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 26, 2010

Payer Source	Total Paid
Medicaid	$904.4K
Medicare	$0

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

23 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…	6,890	$60	$406.6K
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…	3,170	$70	$212.2K
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…	930	$70	$69.1K
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…	630	$80	$47.8K
96110	The 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…	2,510	$20	$40.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	400	$70	$29.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,020	$10	$28.3K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	1,180	$20	$27.2K
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,…	430	$40	$18K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	140	$100	$14K

Showing 1–10 of 23

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

Mid Ohio Valley Medicine & Pediatrics PLLC — 0 of 18 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	274	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…	262	1,030	890	$50	$221K
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…	59	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…	62	140	550	$50	$67.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	86	190	110	$70	$63.4K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	105	110	90	$90	$46.3K
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,…	249	540	320	$20	$43.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	73	190	220	$50	$42.7K
96110	The 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…	27	120	440	$10	$28.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	61	200	360	$20	$26K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rscr West Virginia, Inc.	WV	Developmental Disabilities Clinic/Center	$0	$153.6M
Camden Clark Memorial Hospital Corporation	WV	General Acute Care Hospital	$0	$56.2M
St. Joseph Recovery Center, LLC	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$49.5M
Westbrook Health Services, Inc	WV	Community/Behavioral Health Agency	$0	$42.5M
Westbrook Health Services, Inc.	WV	Community/Behavioral Health Agency	$0	$32.6M
Camden-clark Physician Corporation	WV	Surgery Physician	$0	$19.8M
Wv Family Support And Rehabilitation Services	WV	Community/Behavioral Health Agency	$0	$19.4M
Clean & Clear Advantage, LLC	WV	Addiction (Substance Use Disorder) Counselor	$0	$18.3M
Mjs Enterprises Inc	WV	Land Ambulance	$960.2K	$8.7M
Camden Clark Memorial Hospital Corporation	WV	Land Ambulance	$874.9K	$5.3M

Mid Ohio Valley Medicine & Pediatrics PLLC — Billing Profile & Reimbursement Data

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Mid Ohio Valley Medicine & Pediatrics PLLC — 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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