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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to 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. 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.

Winchester Medical Center (NPI 1760433791)

Winchester Medical Center is a obstetrics & gynecology physician provider located in Winchester, Virginia. This profile covers 0 Medicare and 37 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	Winchester Medical Center
Address	1840 Amherst St
City	Winchester
State	VA
ZIP	22601
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	May 15, 2006

Payer Source	Total Paid
Medicaid	$10M
Medicare	$0

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

37 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	47,300	$90	$4.4M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	30,480	$60	$1.9M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	11,570	$40	$439.8K
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…	8,870	$40	$372.7K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	10,110	$40	$353.7K
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…	5,410	$60	$303.1K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	2,390	$130	$300.5K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	4,340	$70	$295K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	8,950	$30	$286.5K
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…	2,880	$80	$241.8K

Showing 1–10 of 37

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Winchester Medical Center — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	19	340	160	$130	$1.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	97	630	90	$140	$1.1M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	55	620	70	$120	$1M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	169	210	920	$140	$367.6K
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…	448	3,520	370	$70	$280.7K
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…	353	4,010	290	$50	$199.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	78	130	440	$120	$197K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	6	60	280	$110	$167.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	47	400	370	$30	$162.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	72	290	360	$50	$160.1K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Winchester Medical Center	VA	General Acute Care Hospital	$0	$69.9M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Winchester Medical Center	VA	Clinical Medical Laboratory	$2M	$4.8M
Eric Steuer	VA	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Jason Ruggiero	VA	Retina Specialist (Ophthalmology) Physician	$2.5M	$0
Shaina Rubino Loverde	VA	Retina Specialist (Ophthalmology) Physician	$1.8M	$0
Rabia Arshad	VA	Cardiovascular Disease Physician	$469.8K	$0
William Jones	VA	Urology Physician	$468.4K	$0
James Sluss	VA	Diagnostic Radiology Physician	$364K	$90K
Shaik Samdani	VA	Physical Medicine & Rehabilitation Physician	$402.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grafton School, Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$92M
Grafton School Inc	VA	Psychiatric Residential Treatment Facility	$0	$33M
Shenandoah Valley Community Residences, Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.4M
Compassionate Home Care	VA	In Home Supportive Care Agency	$0	$14.5M
Nova Family Services, Inc.	VA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13.5M
Uncle Sam Transportation LLC	VA	Taxi	$0	$12M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$11.2M
Pediatrix Medical Group PC	VA	Neonatal-Perinatal Medicine Physician	$0	$10.8M
Gaurav Agarwal Dds, Msd, PLLC	VA	Dental Clinic/Center	$0	$8.9M
Valley Regional Enterprises, Inc	VA	Urgent Care Clinic/Center	$0	$8.6M

Winchester Medical Center — Billing Profile & Reimbursement Data

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Winchester Medical Center — 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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