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.

Oak Hill Hospital Corporation (NPI 1598736159)

Key Findings

Field	Value
Entity Type	Organization
Organization	Oak Hill Hospital Corporation
Address	430 Main St
City	Oak Hill
State	WV
ZIP	25901
Taxonomy	Critical Access Hospital
NPI Enumerated	January 31, 2006

Payer Source	Total Paid
Medicaid	$18.8M
Medicare	$0

OAK HILL HOSPITAL CORPORATION reports no Medicare billing on file and $18.8M in lifetime Medicaid revenue, making its public payer footprint effectively single‑payer Medicaid in scale. This concentration of reported revenue on Medicaid should be treated as the primary lens for payer/provider comparisons and contracting analysis for this facility.

The provider’s NPI was enumerated 2006-01-31 (~20 years ago), indicating it is an established critical access hospital with a multi‑year presence in its market. That tenure is consistent with the breadth of outpatient and inpatient services reflected in the Medicaid claims mix.

Revenue concentration is meaningful: the top three Medicaid codes 74176, 99283, and 99284 together account for 33.5% of the provider’s total Medicaid revenue, signaling that a relatively small set of ED/imaging codes drives one‑third of reported Medicaid payments. Payers should note this concentration when modeling case mix or negotiating bundled payments.

The code mix points to an ED‑centric acute care operation supported by diagnostic imaging and endoscopy. High claim volumes and revenue for ED E/M codes — 99283 (12.3K claims, $1.6M revenue), 99284 (7.8K claims, $1.5M revenue), and 99285 (4.2K claims, $1.1M revenue) — together with substantial CT activity (74176 $1.7M; 70450 $842.5K) and endoscopy codes like 43239 ($1.0M) and 45385 ($394.1K) indicate the hospital handles a steady stream of emergency presentations and same‑day procedural work.

On statewide competitive standing, the provider is a solid, mid‑tier participant rather than a statewide dominant center for its highest‑revenue services. For example, 74176 ranks #20 of 77 providers in‑state (75th percentile; typical, unremarkable volume), 99283 ranks #38 of 163 (77th percentile; typical, unremarkable volume), and 99284 ranks #46 of 168 (73th percentile; typical, unremarkable volume), which collectively indicate consistent but not exceptional market share for these service lines.

Several ancillary service lines show relatively high throughput for the state: 36415 (venipuncture) reports 20K claims and ranks #32 of 328 providers (91th percentile), 85025 (CBC) shows 17.6K claims and $527.7K revenue (78th percentile), and J3490 (unclassified drugs) is ranked #4 of 51 (94th percentile). These high percentiles for routine lab draws, CBCs, and drug administration suggest robust laboratory and medication administration capacity that supports the hospital’s ED and procedural volumes.

Procedure‑level strengths include endoscopy and interventional imaging: 43239 generates $1.0M (7.1% of Medicaid revenue) and 45385 generates $394.1K (2.8%), with 43239 ranking #20 of 68 (72th percentile) and 45385 ranking #6 of 33 (84th percentile). This pattern points to capability in diagnostic and therapeutic endoscopy that complements emergency care and may represent a referral asset within the region.

From a payer risk and contracting perspective, reliance on a handful of ED and imaging codes for a third of Medicaid revenue, combined with having no Medicare billing on file, creates both negotiating leverage considerations and exposure: reimbursement changes or utilization shifts for those ED/imaging codes could materially affect the hospital’s Medicaid revenue base. Payers should evaluate utilization management and emergency care pathways if they plan payment reforms or network adjustments for this facility.

Medicaid: Complete Services Breakdown

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

144 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	3,030	$560	$1.7M
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.	12,250	$130	$1.6M
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.	7,800	$190	$1.5M
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.	4,210	$260	$1.1M
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	1,410	$710	$1M
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.	16,660	$50	$849.7K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,640	$320	$842.5K
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.	1,190	$540	$649K
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…	17,590	$30	$527.7K
J3490	Unclassified drugs	18,030	$30	$504.8K

Showing 1–10 of 144

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

Oak Hill Hospital Corporation — 0 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

144 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.	44	130	2,090	$210	$1.5M
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.	46	170	3,350	$120	$1.1M
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.	38	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.	35	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.	58	110	2,080	$50	$537.1K
G0378	Hospital observation service, per hour	37	50	940	$140	$363K
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.	29	110	5,530	$20	$344.8K
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.	20	80	1,410	$120	$332.8K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	33	90	1,380	$60	$273.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	34	60	2,600	$40	$245.3K

Showing 1–10 of 144

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Camc Plateau Medical Center, Inc.	WV	Critical Access Hospital	$0	$3.1M
Paul Conley	WV	Internal Medicine Physician	$36.4K	$0
Scott Killmer	WV	Surgery Physician	$17.3K	$0
James Tierney	WV	Urology Physician	$16.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
Oak Hill Emergency Physicians, LLC	WV	Emergency Medicine Physician	$0	$3.8M
Oak Hill Clinic Corp	WV	Family Medicine Physician	$0	$2.3M
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	$1.2M
Adf Behavioral Health Services, LLC	WV	Community/Behavioral Health Agency	$0	$825.9K
Richard Reece	WV	Internal Medicine Physician	$122.1K	$0
Cassandra Ortiz	WV	Optometrist	$28.2K	$0
Michael Buchanan	WV	Optometrist	$19K	$0

Oak Hill Hospital Corporation — 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