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.

New River Health Association, Inc. (NPI 1689669855)

Field	Value
Entity Type	Organization
Organization	New River Health Association, Inc.
Address	30 Grizzley Ln
City	Summersville
State	WV
ZIP	26651
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 14, 2005

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	8,280	$150	$1.3M
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,…	1,960	$10	$9.8K
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…	1,840	$10	$9.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	2,040	$1	$4.1K
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.	460	$10	$2.3K
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…	310	$10	$2.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	30	$0	$0
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	10	$0	$0

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

New River Health Association, Inc. — 0 of 6 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	157	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…	558	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…	681	1,030	890	$50	$221K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	210	210	280	$40	$59.2K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	51	200	490	$30	$57.7K
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,…	108	540	320	$20	$43.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	79	90	190	$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.	141	330	320	$20	$24.4K

Related Providers

Other providers that share a Tax Identification Number (TIN) with New River Health Association, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.2M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
New River Health Association, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.5M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.4M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.2M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.1M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1M
Jawad Zafar	WV	Psychiatry Physician	$46.1K	$4.8K

Nearby Providers

Other providers in the same ZIP code as New River Health Association, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Virginia Health Care Cooperative Inc	WV	Critical Access Hospital	$0	$19.2M
Summersville Pediatrics Inc.	WV	Specialist	$0	$12M
Nicholas Community Action Partnership, Inc.	WV	Point of Service	$0	$6.2M
Summersville Regional Medical Center	WV	Critical Access Hospital	$0	$3.4M
West Virginia Health Care Cooperative Inc	WV	Hospitalist Physician	$0	$3.1M
Nicholas Pharmacy Inc	WV	Oxygen Equipment & Supplies (DME)	$0	$2.2M
Nicholas Community Action Partnership, Inc.	WV	Home Health Agency	$0	$2M
Nicholas Emergency Group, PLLC	WV	Emergency Medicine Physician	$0	$1.6M
West Virginia Health Care Cooperative Inc	WV	Rural Health Clinic/Center	$0	$1.6M
Katherine Wooton	WV	Dentist	$0	$1.2M

New River Health Association, Inc. — Billing Profile & Reimbursement Data

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New River Health Association, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References