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.

Preston Urgent Care Family Practice, LLC (NPI 1720358252)

Field	Value
Entity Type	Organization
Organization	Preston Urgent Care Family Practice, LLC
Address	411 Morgantown St
City	Kingwood
State	WV
ZIP	26537
Taxonomy	Family Nurse Practitioner
NPI Enumerated	December 30, 2011

Payer Source	Total Paid
Medicaid	$1.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

31 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…	11,690	$50	$619.3K
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…	8,170	$70	$563.9K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	2,670	$40	$93.5K
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.	4,820	$20	$77.1K
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…	1,030	$70	$69.7K
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…	3,020	$20	$63.4K
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	800	$40	$32.7K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	2,080	$20	$31.2K
81003	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dipstick, and shakes off the excess urine. She places the stick onto a mechanical dip stick reader that will…	1,460	$20	$26.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,740	$20	$26K

Showing 1–10 of 31

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

Preston Urgent Care Family Practice, LLC — 0 of 25 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

31 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…	195	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…	120	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…	180	340	140	$90	$97.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	119	330	790	$10	$64.1K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	22	100	380	$30	$61.5K
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…	62	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,…	267	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…	50	310	490	$20	$42K
J1885	Injection, ketorolac tromethamine, per 15 mg	45	120	290	$20	$41.7K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	100	140	900	$10	$38.3K

Showing 1–10 of 31

Related Providers

Other providers that share a Tax Identification Number (TIN) with Preston Urgent Care Family Practice, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Peggy Phillips	WV	Family Nurse Practitioner	$16.3K	$0

Nearby Providers

Other providers in the same ZIP code as Preston Urgent Care Family Practice, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Preston Memorial Hospital Corporation	WV	Critical Access Hospital	$0	$20.2M
Preston Health Care Services LLC	WV	Family Health Clinical Nurse Specialist	$0	$3M
Preston Memorial Hospital Corporation	WV	Emergency Medicine Physician	$0	$2.6M
Kamp Central Ambulance Service, Inc.	WV	Land Ambulance	$280.9K	$1.9M
Tracy Underwood	WV	Family Nurse Practitioner	$45.2K	$0
Ashley Gardo	WV	Speech-Language Pathologist	$31.6K	$0
Robin Goodwin	WV	Family Nurse Practitioner	$21.6K	$0
Courtney Swisher	WV	Family Nurse Practitioner	$21.3K	$0
County Of Preston Board Of Health	WV	Public Health & General Preventive Medicine Physician	$5.6K	$10.7K
Jamie Richardson	WV	Certified Registered Nurse Anesthetist	$14.7K	$0

Preston Urgent Care Family Practice, LLC — Billing Profile & Reimbursement Data

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Preston Urgent Care Family Practice, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References