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.

Carl High (NPI 1700808177)

Field	Value
Entity Type	Individual
Organization	Carl High
Address	909 Gorman Ave
City	Elkins
State	WV
ZIP	26241
Taxonomy	Family Medicine Physician
NPI Enumerated	July 24, 2006

Payer Source	Total Paid
Medicare	$184.5K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	1,750	$70	$125.8K
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…	610	$80	$47.5K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	1,200	$10	$12K
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…	20	$20	$300
G0008	Administration of influenza virus vaccine	20	$20	$300

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 5 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Carl High — 2 of 5 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. state median

5 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99309	6	160	160	$70	$26.3K
95165	8	20	700	$10	$17.6K
99214	111	2,740	100	$70	$11.8K
G0008	514	560	50	$30	$2K
90686	56	90	20	$20	$590

Nearby Providers

Other providers in the same ZIP code as Carl High, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Select In Home Services, Inc.	WV	Personal Care Attendant	$0	$25.7M
Davis Memorial Hospital	WV	General Acute Care Hospital	$0	$20.1M
Ems, Inc.	WV	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$17.6M
Mountaineer Home Care Services LLC	WV	In Home Supportive Care Agency	$0	$12.4M
Youth Health Service, Inc	WV	Community/Behavioral Health Agency	$0	$9.8M
Appalachian Community Health Center	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.6M
Wendy Collins	WV	Homemaker	$0	$7.6M
Valley Health Care, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$7.6M
Randolph County Court Emergency Squad	WV	Land Ambulance	$1M	$5.3M
Drs Wilson And Martino Of Elkins	WV	General Practice Dentistry	$0	$5.8M

Carl High — Billing Profile & Reimbursement Data

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Carl High — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References