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.

Montgomery General Hospital, Inc (NPI 1619913647)

Montgomery General Hospital, Inc is a critical access hospital provider located in Montgomery, West Virginia. This profile covers 0 Medicare and 117 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	Montgomery General Hospital, Inc
Address	401 6th Ave
City	Montgomery
State	WV
ZIP	25136
Taxonomy	Critical Access Hospital
NPI Enumerated	June 20, 2006

Payer Source	Total Paid
Medicaid	$9.4M
Medicare	$0

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

117 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.	7,120	$150	$1.1M
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.	5,930	$170	$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.	7,610	$120	$905.8K
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.	15,440	$40	$602.1K
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.	1,450	$360	$515.1K
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.	3,090	$130	$398.9K
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…	17,970	$20	$359.4K
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…	6,560	$40	$269.1K
84484	The lab analyst performs the technical lab test typically using serum, plasma, or whole blood to quantitate troponin. Troponin is a protein labs commonly measure to verify a myocardial infarction and…	5,620	$50	$264K
84145	The lab analyst performs a test to evaluate the level of procalcitonin, also called PCT or ProCT, in a patient specimen such as serum.	2,500	$90	$217.6K

Showing 1–10 of 117

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

Montgomery General Hospital, Inc — 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

117 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.	36	130	2,090	$210	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	44	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.	44	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.	52	170	3,350	$120	$1.1M
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	18	30	180	$40	$773.3K
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.	50	160	3,690	$80	$714.8K
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.	76	110	2,080	$50	$537.1K
87633	The lab analyst performs a test to identify a respiratory virus using amplified nucleic acid probe technique. He may also use a multiplex reverse transcription technique. The provider does this for…	17	30	300	$240	$420K
G0378	Hospital observation service, per hour	23	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.	32	110	5,530	$20	$344.8K

Showing 1–10 of 117

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Matthew Hrastich	MO	Diagnostic Radiology Physician	$134.1K	$399.7K
Kalpesh Patel	AZ	Diagnostic Radiology Physician	$409.1K	$0
Crysela Smith	TX	Diagnostic Radiology Physician	$249.7K	$0
Michael Anton	WV	Diagnostic Radiology Physician	$241.7K	$0
Scott Akin	AL	Diagnostic Radiology Physician	$189K	$52.6K
Jeffrey Boss	MO	Diagnostic Radiology Physician	$154.5K	$72.3K
Adam Evans	OH	Diagnostic Radiology Physician	$223.2K	$0
Nathan Bennington	OH	Diagnostic Radiology Physician	$215.3K	$0
Augustus Key	KY	Diagnostic Radiology Physician	$212.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Montgomery General Hospital, Inc	WV	Rural Health Clinic/Center	$0	$2.3M
Ghassan Dagher	WV	Ophthalmology Physician	$26.9K	$263.8K
Robert Eggleston	WV	Internal Medicine Physician	$37.7K	$0
Sammar Atassi	WV	Sleep Medicine (Internal Medicine) Physician	$8.4K	$0

Montgomery General Hospital, Inc — Billing Profile & Reimbursement Data

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Montgomery General Hospital, Inc — 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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