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.

Wellmont Health System (NPI 1801826912)

Wellmont Health System is a general acute care hospital provider located in Big Stone Gap, Virginia. This profile covers 0 Medicare and 328 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	Wellmont Health System
Address	1990 Holton Ave E
City	Big Stone Gap
State	VA
ZIP	24219
Taxonomy	General Acute Care Hospital
NPI Enumerated	July 4, 2006

Payer Source	Total Paid
Medicaid	$33.7M
Medicare	$0

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

328 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	39,310	$160	$6.4M
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.	24,760	$130	$3.3M
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.	20,580	$150	$3M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	10,270	$260	$2.6M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6,700	$200	$1.3M
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	6,700	$160	$1.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	7,980	$120	$973.6K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	4,220	$200	$834.6K
0241U	N/A	14,530	$60	$798.9K
96366	The provider administers an intravenous infusion or infusions of a medication for an additional hour or subsequent hours after the first hour to prevent, treat, or diagnose a condition or disease.	3,300	$220	$725.8K

Showing 1–10 of 328

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

Wellmont Health System — 1 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

328 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	10	10	800	$5,190	$4.6M
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	38	90	9,030	$280	$3.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	38	70	3,200	$110	$2.8M
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.	48	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.	62	630	90	$140	$1.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	38	140	3,240	$160	$1M
G0378	Hospital observation service, per hour	40	80	3,650	$160	$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.	41	620	70	$120	$1M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	52	180	2,950	$140	$783.2K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	224	260	3,950	$80	$769.6K

Showing 1–10 of 328

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellmont Medical Associates Inc	VA	Family Medicine Physician	$0	$24.6M
Frontier Health	VA	Developmentally Disabled Services Day Training Agency	$0	$11.9M
Karen Stallard	VA	Family Nurse Practitioner	$58.1K	$5.3K
Robert Botts	VA	Optometrist	$38.9K	$5.4K
Joshua Dalton	VA	Neuromusculoskeletal Medicine & OMM Physician	$34.4K	$0
Ginger Collins	VA	Nurse Practitioner	$32.7K	$0

Wellmont Health System — Billing Profile & Reimbursement Data

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Wellmont Health System — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wellmont Health System	TN	General Acute Care Hospital	$0	$27.3M
Wellmont Health System	TN	General Acute Care Hospital	$0	$17.6M
Elizabeth Jackson	TN	Surgery Physician	$23.5K	$0