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.

Lorraine Surgical Supply Of West Virginia Inc. (NPI 1710915723)

Field	Value
Entity Type	Organization
Organization	Lorraine Surgical Supply Of West Virginia Inc.
Address	99 Edgington Lane
City	Wheeling
State	WV
ZIP	26003
Taxonomy	Durable Medical Equipment & Medical Supplies
NPI Enumerated	June 29, 2006

Payer Source	Total Paid
Medicaid	$34.6M
Medicare	$0

Key Findings

This provider has no Medicare billing on file and is effectively a single-payer Medicaid supplier, reporting Total Medicaid revenue of $34.6M. The absence of Medicare activity makes Medicaid the sole public payer driver of reported revenue and should be treated as the primary lens for competitive and utilization analysis.

Revenue is extremely concentrated: the precomputed top 3 Medicaid codes by revenue account for 99.8% of the provider's total Medicaid revenue. Those top three line items are A4520 ($31M, 89.8%), A4554 ($3.2M, 9.2%), and A4351 ($287.1K, 0.8%), indicating almost all revenue derives from a very small set of product categories.

The code mix and descriptions indicate a business focused on high-volume consumable incontinence supplies and related urology disposables. Dominant codes A4520 (incontinence garments) and A4554 (disposable underpads) point to large-scale distribution of single-use incontinence products, with A4351 (intermittent urinary catheters) representing a smaller but related urology supply line. This mix is consistent with a DME supplier whose operations center on recurring, high-frequency consumables rather than durable equipment sales.

On statewide competitive standing the provider is a clear leader for its top items: A4520 ranks #1 of 32 providers in-state (100th percentile; described as an extreme outlier, far above typical state volume for this code) and A4554 ranks #1 of 24 providers in-state (100th percentile; also an extreme outlier). A4351 likewise ranks #1 of 5 providers in-state (100th percentile; notably above typical state volume for this code). These rank positions indicate dominance in West Virginia for the core product categories driving its Medicaid revenue.

Operational throughput is very high in the two core consumable lines, with 287.4K claims for A4520 and 167.2K claims for A4554 reported on file. Such large claim volumes imply a scale of transactional processing, inventory turnover, and distribution logistics aligned to repeated consumable fulfillment rather than episodic durable-goods sales.

Smaller revenue lines are present but immaterial to total revenue: A6250 (3K claims, $32.5K, 0.1%) and E0603 (317 claims, $13.3K) and T4535 (350 claims, $7K) each contribute only fractional shares and are described as typical, unremarkable volumes. A4357, A4358, and A4349 appear with very small claim and revenue counts and mixed rank positions (some #1 of small peer sets, some #2), reinforcing that the provider’s business is narrowly concentrated in a few consumable codes.

This concentration creates revenue sensitivity: because A4520 and A4554 together account for the overwhelming majority of Medicaid dollars, changes in coverage policy, reimbursement rates, or beneficiary demand for those specific incontinence product codes would disproportionately affect the provider’s overall Medicaid revenue. Stakeholders should monitor state policy and rate changes for these specific HCPCS codes when assessing financial or contract risk.

The provider has an NPI enumeration date of 2006-06-29 (~20 years ago), indicating long tenure in the market. Combined with its dominant statewide ranking on key consumable codes, this tenure suggests established operational relationships with West Virginia Medicaid and a sustained focus on high-volume incontinence and related urology supply distribution.

Medicaid: Complete Services Breakdown

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

9 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	287,380	$110	$31M
A4554	Disposable underpads, all sizes	167,250	$20	$3.2M
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	2,370	$120	$287.1K
A6250	Skin sealants, protectants, moisturizers, ointments, any type, any size	2,960	$10	$32.5K
E0603	Breast pump, electric (ac and/or dc), any type	320	$40	$13.3K
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	350	$20	$7K
A4357	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each	240	$10	$3.1K
A4358	Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each	70	$20	$1.2K
A4349	Male external catheter, with or without adhesive, disposable, each	30	$30	$920

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

Lorraine Surgical Supply Of West Virginia Inc. — 6 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

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	1	30	2,020	$110	$1.3M
A4554	Disposable underpads, all sizes	1	20	670	$20	$166.3K
A4351	Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each	1	10	290	$100	$72.4K
A6250	Skin sealants, protectants, moisturizers, ointments, any type, any size	1	10	1,510	$20	$33.4K
E0603	Breast pump, electric (ac and/or dc), any type	1	10	180	$40	$7.5K
T4535	Disposable liner/shield/guard/pad/undergarment, for incontinence, each	1	10	270	$20	$5.3K
A4357	Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each	2	10	440	$10	$3.5K
A4358	Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each	2	10	260	$10	$1.7K
A4349	Male external catheter, with or without adhesive, disposable, each	1	10	30	$30	$930

Nearby Providers

Other providers in the same ZIP code as Lorraine Surgical Supply Of West Virginia Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwood Health Systems Inc	WV	Developmentally Disabled Services Day Training Agency	$0	$67.6M
Northwood Health Systems Inc	WV	Community/Behavioral Health Agency	$0	$52.5M
Wheeling Hospital Inc	WV	General Acute Care Hospital	$0	$40.1M
Russell Nesbitt Services Inc	WV	Respite Care	$0	$29.5M
Florence Crittenton Programs, Inc.	WV	Mental Health Counselor	$0	$14.4M
Wheeling Hospital Inc	WV	Family Medicine Physician	$0	$8.5M
Lifeline Addiction Specialists, PLLC	WV	Multi-Specialty Clinic/Center	$0	$7M
Radiology Associates, Inc	WV	Diagnostic Radiology Physician	$0	$6.7M
Serenity Hills Life Center	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.1M
Alecto Healthcare Services Wheeling LLC	WV	General Acute Care Hospital	$0	$6M

Lorraine Surgical Supply Of West Virginia Inc. — Billing Profile & Reimbursement Data

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Lorraine Surgical Supply Of West Virginia Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References