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.

Tug Valley Wellness Center, LLC (NPI 1659993350)

Tug Valley Wellness Center, LLC is a family medicine physician provider located in Williamson, West Virginia. This profile covers 0 Medicare and 21 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	Tug Valley Wellness Center, LLC
Address	50 Lenore Business Mall
City	Williamson
State	WV
ZIP	25661
Taxonomy	Family Medicine Physician
NPI Enumerated	May 15, 2020

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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
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…	9,790	$50	$528.9K
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…	5,950	$70	$404.4K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	7,690	$10	$92.2K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	3,050	$30	$91.5K
86328	The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2…	2,080	$30	$58.3K
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…	580	$90	$54.6K
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.	2,190	$10	$26.2K
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…	870	$10	$9.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,510	$10	$7.6K
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…	70	$70	$5.2K

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

Tug Valley Wellness Center, LLC — 1 of 21 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
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…	218	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…	157	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…	75	340	140	$90	$97.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	131	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…	261	440	110	$60	$57.2K
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…	117	310	490	$20	$42K
86328	The lab analyst performs a single–step immunoassay to qualitatively or semiquantitatively evaluate the patient’s specimen for antibodies to the severe acute respiratory syndrome coronavirus 2…	2	10	290	$30	$25.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	156	180	140	$50	$24.8K
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.	52	330	320	$20	$24.4K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	6	70	130	$20	$23.3K

Showing 1–10 of 21

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Williamson Health & Wellness Center Inc	WV	Federally Qualified Health Center (FQHC)	$0	$12.8M
Lighthouse Community Investment Agency Inc	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$9.8M
Williamson Treatment Center, LLC	WV	Methadone Clinic	$446.4K	$8.9M
Williamson Health & Wellness Center Inc	WV	Federally Qualified Health Center (FQHC)	$0	$5.5M
Aurora Project Associates LLC	WV	Substance Abuse Rehabilitation Facility	$0	$5.1M
Ohio Valley Physicians Inc	WV	Rural Health Clinic/Center	$0	$4.2M
Williamson Memorial Hospital LLC	WV	General Acute Care Hospital	$0	$3.7M
Coalfield Community Action Partners	WV	Personal Care Attendant	$0	$1.9M
Williamson Treatment Center, LLC	WV	Methadone Clinic	$0	$1.6M
Coalfield Community Action Partners	WV	Homemaker	$0	$1.3M

Tug Valley Wellness Center, LLC — Billing Profile & Reimbursement Data

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Tug Valley Wellness Center, LLC — 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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