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.

Grant Memorial Hospital (NPI 1598763666)

Grant Memorial Hospital is a critical access hospital provider located in Petersburg, West Virginia. This profile covers 0 Medicare and 148 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	Grant Memorial Hospital
Address	117 Hospital Dr
City	Petersburg
State	WV
ZIP	26847
Taxonomy	Critical Access Hospital
NPI Enumerated	July 12, 2005

Payer Source	Total Paid
Medicaid	$13M
Medicare	$0

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

148 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	12,610	$290	$3.6M
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.	7,000	$180	$1.3M
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.	4,040	$310	$1.2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	3,900	$140	$553.5K
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.	970	$450	$437.3K
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…	13,790	$20	$303.4K
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.	11,230	$30	$291.9K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	5,260	$50	$247.1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	14,230	$20	$242K
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.	1,950	$120	$235.6K

Showing 1–10 of 148

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

Grant Memorial Hospital — 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

148 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.	49	130	2,090	$210	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	23	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.	23	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.	36	170	3,350	$120	$1.1M
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	20	20	720	$20	$721.7K
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.	52	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.	38	80	950	$140	$559.5K
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…	24	50	800	$70	$504.4K
G0378	Hospital observation service, per hour	30	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.	41	110	5,530	$20	$344.8K

Showing 1–10 of 148

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grant Memorial Hospital Inc	WV	Critical Access Hospital	$0	$2.4M
David Weber	PA	Specialist	$292.8K	$498.8K
John Lobban	WV	Clinical Cardiac Electrophysiology Physician	$167.7K	$0
Stephen Thompson	WV	Internal Medicine Physician	$99.4K	$6.8K
Benjamin Leslie	WV	Internal Medicine Physician	$87.8K	$7.5K
Brian Kazienko	WV	Cardiovascular Disease Physician	$86.1K	$7K
Caroline Armstrong	WV	Internal Medicine Physician	$75K	$10.1K
Brian Richardson	WV	Emergency Medicine Physician	$80K	$0
Brandon Wilson	WV	General Practice Physician	$62.3K	$6.4K
David Deuell	WV	Emergency Medicine Physician	$63.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Potomac Highlands Guild	WV	Community/Behavioral Health Agency	$0	$38.9M
Potomac Highlands Mental Health Guild, Inc.	WV	Community/Behavioral Health Agency	$0	$17.1M
E. A. Hawse Health Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$7.8M
Commission On Aging Family Services	WV	Community Based Hospice Care Agency	$0	$3.3M
John L Hahn Md Inc	WV	Obstetrics & Gynecology Physician	$0	$1.4M
County Of Grant	WV	Land Ambulance	$271.5K	$998.9K
Khaled Said	WV	Emergency Medicine Physician	$81.7K	$1.5K
Heather Barger	WV	Family Nurse Practitioner	$53.5K	$870
Theodore Weitz	WV	Emergency Medicine Physician	$42.4K	$0
Melissa Mathias	WV	Family Nurse Practitioner	$36.2K	$0

Grant Memorial Hospital — Billing Profile & Reimbursement Data

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Grant Memorial Hospital — 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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