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.

Richard Spencer (NPI 1568422640)

Field	Value
Entity Type	Individual
Organization	Richard Spencer
Address	497 Mall Rd
City	Oak Hill
State	WV
ZIP	25901
Taxonomy	Family Medicine Physician
NPI Enumerated	March 24, 2006

Payer Source	Total Paid
Medicare	$3K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
94729	In this add on procedure, the provider tests the lungs’ diffusing capacity, the ability to exchange gases, moving oxygen into the bloodstream and letting in carbon dioxide from the bloodstream.	40	$20	$960
94726	The provider performs a pulmonary function test, or PFT, to determine the patient’s lung volumes, such as total lung capacity, residual volume, and functional residual capacity. The testing also may…	30	$20	$570
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	30	$20	$560
94618	The provider performs pulmonary stress testing to evaluate lung function and to diagnose certain lung disorders. The stress component may include a six–minute walk test or other form of exercise.	30	$20	$550
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	20	$10	$180
94664	The provider educates a patient on the use of an aerosol device, nebulizer, metered dose inhaler, or IPPB device and then has the patient demonstrate her understanding. He does this as part of the…	20	$10	$150

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Richard Spencer — 0 of 6 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. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
94729	44	70	50	$20	$1.5K
94726	43	60	40	$20	$1.3K
71046	230	300	40	$10	$1.3K
94060	41	70	40	$20	$1.2K
94618	14	30	30	$20	$490
94664	2	10	20	$10	$210

Related Providers

Other providers that share a Tax Identification Number (TIN) with Richard Spencer, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.2M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
New River Health Association, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.5M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.4M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.3M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.2M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.1M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1M

Nearby Providers

Other providers in the same ZIP code as Richard Spencer, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oak Hill Hospital Corporation	WV	Critical Access Hospital	$0	$18.8M
Oak Hill Emergency Physicians, LLC	WV	Emergency Medicine Physician	$0	$3.8M
Camc Plateau Medical Center, Inc.	WV	Critical Access Hospital	$0	$3.1M
Oak Hill Clinic Corp	WV	Family Medicine Physician	$0	$2.3M
Adf Behavioral Health Services, LLC	WV	Community/Behavioral Health Agency	$0	$825.9K
Richard Reece	WV	Internal Medicine Physician	$122.1K	$0
Paul Conley	WV	Internal Medicine Physician	$36.4K	$0
Cassandra Ortiz	WV	Optometrist	$28.2K	$0
Michael Buchanan	WV	Optometrist	$19K	$0
Krystal Smithers	WV	Medical Physician Assistant	$13.4K	$0

Richard Spencer — Billing Profile & Reimbursement Data

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Richard Spencer — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References