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.

St. Joseph's Hospital Of Buckhannon, Inc. (NPI 1780223370)

St. Joseph's Hospital Of Buckhannon, Inc. is a rural health clinic/center provider located in Buckhannon, West Virginia. This profile covers 0 Medicare and 26 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	St. Joseph's Hospital Of Buckhannon, Inc.
Address	94 W Main St
City	Buckhannon
State	WV
ZIP	26201
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	December 30, 2019

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	19,680	$110	$2.2M
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…	5,160	$1	$5.2K
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…	4,980	$1	$5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	580	$1	$580
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,960	$0	$0
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	840	$0	$0
90633	This code represents a vaccine product administered into a muscle to protect against hepatitis A, a liver infection. This code is specific to a pediatric/adolescent dosage with a two–dose schedule.	50	$0	$0
90648	This code represents a Haemophilus influenzae type b (Hib) vaccine product administered into the muscle to protect against Hib disease. This formulation uses a PRP–T conjugate and follows a four–dose…	190	$0	$0
90670	This code represents a pneumococcal vaccine product administered into the muscle to protect against 13 types of pneumococcal bacteria that can cause serious infections like pneumonia, meningitis, and…	200	$0	$0
90680	This code represents a live pentavalent rotavirus vaccine given by mouth in a three–dose schedule to protect against rotavirus infection.	60	$0	$0

Showing 1–10 of 26

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

St. Joseph's Hospital Of Buckhannon, Inc. — 0 of 4 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

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	101	390	4,610	$130	$2.2M
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…	334	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…	186	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…	206	340	140	$90	$97.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	69	150	520	$50	$76.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	68	140	550	$50	$67.2K
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,…	248	540	320	$20	$43.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	91	190	220	$50	$42.7K
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…	225	310	490	$20	$42K
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…	54	80	310	$10	$37.1K

Showing 1–10 of 26

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs Hospital Of Buckhannon Inc	WV	Critical Access Hospital	$0	$41.8M
St Josephs Hospital Of Buckhannon	WV	Internal Medicine Physician	$0	$4.5M
St. Joseph's Hospital Of Buckhannon, Inc.	WV	Rural Health Clinic/Center	$0	$1.1M
David Waxman	WV	Adult Reconstructive Orthopaedic Surgery Physician	$163.8K	$0
David Tingler	WV	Cardiovascular Disease Physician	$145.7K	$0
Paul Brager	WV	Hematology & Oncology Physician	$129.5K	$0
David Faber	WV	Surgery Physician	$123.5K	$0
Brian Mcmillan	WV	Ophthalmology Physician	$113.6K	$0
Thomas Mauger	WV	Ophthalmology Physician	$94.8K	$0
Brian Kazienko	WV	Cardiovascular Disease Physician	$86.1K	$7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central West Virginia Aging Services Inc (hmkr)	WV	Home Health Agency	$0	$61.8M
Central West Virginia Aging Services, Inc. (cm)	WV	Case Management Agency	$0	$8.6M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$6.3M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$5.1M
Drs Martino & Wilson, PLLC	WV	General Practice Dentistry	$0	$4.1M
Upshur County Emergency Medical Services Inc	WV	Land Ambulance	$336.2K	$3.6M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$3.5M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$3M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$867.3K
Allison Bardes	WV	Ophthalmology Physician	$172.5K	$0

St. Joseph's Hospital Of Buckhannon, Inc. — 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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