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.

Braxton County Memorial Hospital (NPI 1639278518)

Field	Value
Entity Type	Organization
Organization	Braxton County Memorial Hospital
Address	617 River St
City	Gassaway
State	WV
ZIP	26624
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	September 21, 2006

Payer Source	Total Paid
Medicaid	$2.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	22,450	$120	$2.6M
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…	7,330	$20	$139.3K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	11,090	$1	$11.1K
99203	The provider sees a new 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 provider…	130	$50	$7K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	250	$20	$3.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	480	$10	$3.8K
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,…	260	$10	$2.9K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	220	$10	$1.3K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	20	$1	$20
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	3,080	$0	$0

Showing 1–10 of 21

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

Braxton County Memorial Hospital — 0 of 9 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	91	390	4,610	$130	$2.2M
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…	260	1,270	1,240	$30	$245K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	87	1,030	890	$50	$221K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	234	340	140	$90	$97.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	90	330	790	$10	$64.1K
99203	The provider sees a new 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 provider…	200	440	110	$60	$57.2K
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,…	278	540	320	$20	$43.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	201	310	490	$20	$42K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	193	200	360	$20	$26K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	301	330	320	$20	$24.4K

Showing 1–10 of 21

Related Providers

Other providers that share a Tax Identification Number (TIN) with Braxton County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Braxton County Memorial Hospital	WV	Critical Access Hospital	$0	$4.9M
Braxton County Memorial Hospital	WV	Critical Access Hospital	$0	$2.2M
Brian Richardson	WV	Emergency Medicine Physician	$80K	$0
Brandon Wilson	WV	General Practice Physician	$62.3K	$6.4K
Dennis Laird	CT	Emergency Medicine Physician	$68.3K	$0
Yaoxian Ding	RI	Anatomic Pathology & Clinical Pathology Physician	$36.9K	$22.7K
Howard Lafferty	WV	Family Medicine Physician	$57.2K	$0
Matthew Szarko	WV	Anatomic Pathology & Clinical Pathology Physician	$55K	$0
Ronald Pearson	GA	Surgery Physician	$54.9K	$0
Gerald Wedemeyer	WV	Clinical Pathology/Laboratory Medicine Physician	$53.4K	$0

Nearby Providers

Other providers in the same ZIP code as Braxton County Memorial Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Greenbrier Emergency Services, Inc.	WV	Emergency Medicine Physician	$0	$18.1M
Chad Lancaster	WV	General Practice Dentistry	$0	$1.2M

Braxton County Memorial Hospital — Billing Profile & Reimbursement Data

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Braxton County 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

Related Providers

Nearby Providers

Frequently Asked Questions

References