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.

Drs Whittington & Whittington Ptr (NPI 1629130810)

Field	Value
Entity Type	Organization
Organization	Drs Whittington & Whittington Ptr
Address	3840 Pennsylvania Ave
City	Charleston
State	WV
ZIP	25302
Taxonomy	Optometrist
NPI Enumerated	December 14, 2006

Payer Source	Total Paid
Medicaid	$865.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	3,870	$80	$301.7K
V2020	Frames, purchases	3,870	$60	$240.1K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	950	$100	$91.9K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	5,560	$20	$89K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	1,510	$40	$60.5K
S0580	Polycarbonate lens (list this code in addition to the basic code for the lens)	1,820	$30	$47.3K
V2410	Variable asphericity lens, single vision, full field, glass or plastic, per lens	190	$120	$23.5K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	290	$30	$8.7K
V2104	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens	30	$30	$1.2K
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…	20	$60	$830

Showing 1–10 of 11

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

Drs Whittington & Whittington Ptr — 1 of 11 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

11 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…	1,223	1,270	1,240	$30	$245K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	8	140	550	$70	$70.2K
V2020	Frames, purchases	9	130	510	$60	$61.5K
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,…	521	540	320	$20	$43.2K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	24	120	270	$80	$42.5K
S0580	Polycarbonate lens (list this code in addition to the basic code for the lens)	15	80	510	$30	$31.7K
V2103	Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens	16	90	300	$40	$31.6K
V2410	Variable asphericity lens, single vision, full field, glass or plastic, per lens	2	10	190	$60	$23.8K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	5	130	530	$10	$17.7K
V2100	Sphere, single vision, plano to plus or minus 4.00, per lens	30	80	140	$30	$10.3K

Showing 1–10 of 11

Nearby Providers

Other providers in the same ZIP code as Drs Whittington & Whittington Ptr, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthnet Aeromedical Services Inc.	WV	Air Ambulance	$4.1M	$24.1M
Home Base Inc.	WV	Community/Behavioral Health Agency	$0	$14.5M
Appalachian Labs Of Wv LLC	WV	Clinical Medical Laboratory	$359.3K	$11M
Womencare Inc	WV	Federally Qualified Health Center (FQHC)	$0	$7.4M
Allied Nursing And Community Service	WV	Case Management Agency	$0	$5.4M
Devaraj Behavioral Healthcare PLLC	WV	Community/Behavioral Health Agency	$0	$4.8M
Pediatrix Medical Group PC	WV	Neonatal-Perinatal Medicine Physician	$0	$3.7M
South Charleston Pediatrics	WV	Pediatrics Physician	$0	$3.6M
Abc Pediatrics, PLLC	WV	Pediatrics Physician	$0	$2.9M
Kanawha Valley Senior Services	WV	Home Health Agency	$0	$2.2M

Drs Whittington & Whittington Ptr — Billing Profile & Reimbursement Data

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Drs Whittington & Whittington Ptr — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References