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    OpenPayerNPI Medicare & MedicaidCommunity Care Of West Virginia, Inc.
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    Community Care Of West Virginia, Inc. — Billing Profile & Reimbursement Data

    NPI 1770917577 · Sutton, WV · Federally Qualified Health Center (FQHC)

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    Community Care Of West Virginia, Inc. is a federally qualified health center (fqhc) provider located in Sutton, West Virginia. This profile covers 0 Medicare and 39 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationCommunity Care Of West Virginia, Inc.
    Address266 Skidmore Ln
    CitySutton
    StateWV
    ZIP26601
    TaxonomyFederally Qualified Health Center (FQHC)
    NPI EnumeratedAugust 28, 2013

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$4.9M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    39 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive26,970$170$4.7M
    99213The 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…12,200$10$73.2K
    99214The 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…8,720$10$69.8K
    87428The 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…1,820$20$38.3K
    G0511Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…1,840$10$12.9K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.410$20$8.9K
    99396The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.170$30$4.8K
    90674This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…40$90$3.3K
    90686This 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…190$10$2.1K
    81003The 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…120$10$710

    Showing 1–10 of 39

    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.

    Full comparison — all codes billed, vs. West Virginia median

    39 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive813904,610$130$2.2M
    H0004Behavioral health counseling and therapy, per 15 minutes1651708,500$80$1.5M
    99213The 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…1841,2701,240$30$245K
    99214The 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…1111,030890$50$221K
    90837In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…201310740$80$178.2K
    90792In 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…46100120$100$69.6K
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.308330790$10$64.1K
    90834In 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…141210280$40$59.2K
    90832In 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…162200490$30$57.7K
    99203The 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…298440110$60$57.2K

    Showing 1–10 of 39

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Community Care Of West Virginia, Inc., ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$11M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$9.3M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$9.1M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$7.7M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$6.3M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$6.3M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$5.1M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$4.4M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$4.1M
    Community Care Of West Virginia, Inc.WVFederally Qualified Health Center (FQHC)$0$3.5M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Braxton County Senior Citizens Center, Inc.WVPersonal Care Attendant$0$6.6M
    Braxton County Senior Citizens Center, Inc.WVHome Health Agency$0$6.2M
    Braxton County Emergency Ambulance Service AuthorityWVLand Ambulance$133.5K$1.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. West Virginia Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. West Virginia Distribution
    Community Care Of West Virginia, Inc. — 0 of 16 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — West Virginia