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.

Prompt Care, Inc. (NPI 1790115848)

Prompt Care, Inc. is a basic emergency medical technician provider located in Glen Morgan, West Virginia. This profile covers 0 Medicare and 19 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	Prompt Care, Inc.
Address	703 Ritter Dr
City	Glen Morgan
State	WV
ZIP	25813
Taxonomy	Basic Emergency Medical Technician
NPI Enumerated	November 26, 2013

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

19 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…	15,650	$50	$719.9K
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…	2,640	$70	$177.1K
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…	1,410	$60	$90K
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.	5,510	$20	$82.6K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	2,090	$20	$43.9K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	1,040	$30	$34.3K
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…	2,190	$10	$26.3K
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,…	710	$30	$23.3K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	390	$40	$15.1K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	60	$120	$7.5K

Showing 1–10 of 19

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

Prompt Care, Inc. — 0 of 19 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

19 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…	145	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…	303	1,030	890	$50	$221K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	133	140	1,090	$20	$104.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	212	330	790	$10	$64.1K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	17	50	560	$50	$57.6K
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…	52	440	110	$60	$57.2K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	27	30	160	$60	$55.6K
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,…	200	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…	66	310	490	$20	$42K
J1885	Injection, ketorolac tromethamine, per 15 mg	63	120	290	$20	$41.7K

Showing 1–10 of 19

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rhonda Ray	WV	Family Nurse Practitioner	$128.8K	$0
Skylar Marsh	WV	Family Nurse Practitioner	$16.8K	$0
Samantha Miller	WV	Family Nurse Practitioner	$14.2K	$0
Tracy Basham	WV	Family Nurse Practitioner	$3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beckley Treatment Center, LLC	WV	Methadone Clinic	$392.1K	$15.4M
Rainbow Pediatrics, Inc	WV	Pediatrics Physician	$0	$7.4M
Anchor Medical LLC	WV	Nurse Practitioner	$0	$4.6M
Beckley Treatment Center, LLC	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$1.6M
James Beaver	WV	Physician Assistant	$84.9K	$0
Bella Zinzuwadia	WV	Internal Medicine Physician	$83.7K	$0
Conley White	WV	Family Nurse Practitioner	$18.2K	$0

Prompt Care, Inc. — Billing Profile & Reimbursement Data

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Prompt Care, 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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