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.

Preston Health Care Services LLC (NPI 1811220643)

Preston Health Care Services LLC is a family health clinical nurse specialist provider located in Kingwood, West Virginia. This profile covers 0 Medicare and 38 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	Preston Health Care Services LLC
Address	1343 N Preston Hwy
City	Kingwood
State	WV
ZIP	26537
Taxonomy	Family Health Clinical Nurse Specialist
NPI Enumerated	September 11, 2009

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

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

38 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…	41,100	$60	$2.3M
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…	2,540	$80	$190.4K
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…	1,420	$80	$109K
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…	5,890	$20	$100.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	1,400	$40	$57.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	4,000	$10	$48K
J2930	Injection, methylprednisolone sodium succinate, up to 125 mg	1,880	$10	$20.7K
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…	530	$40	$19.6K
81000	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	640	$20	$12.1K
J1885	Injection, ketorolac tromethamine, per 15 mg	2,060	$10	$10.3K

Showing 1–10 of 38

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

Preston Health Care Services LLC — 1 of 25 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

38 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96156	The provider assesses psychological, behavioral, emotional, cognitive, and social factors that affect a patient’s physical health, rather than assessing a specific mental health disorder. There are…	6	10	60	$170	$888.7K
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…	46	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…	308	1,030	890	$50	$221K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	58	60	2,090	$60	$209.1K
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…	81	140	1,090	$20	$104.5K
Q3014	Telehealth originating site facility fee	76	80	580	$20	$104.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	18	90	170	$60	$72.3K
81000	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	6	10	450	$10	$65.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	76	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	47	50	560	$50	$57.6K

Showing 1–10 of 38

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Robin Goodwin	WV	Family Nurse Practitioner	$21.6K	$0
Courtney Swisher	WV	Family Nurse Practitioner	$21.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Preston Memorial Hospital Corporation	WV	Critical Access Hospital	$0	$20.2M
Preston Memorial Hospital Corporation	WV	Emergency Medicine Physician	$0	$2.6M
Kamp Central Ambulance Service, Inc.	WV	Land Ambulance	$280.9K	$1.9M
Preston Urgent Care Family Practice, LLC	WV	Family Nurse Practitioner	$0	$1.7M
Tracy Underwood	WV	Family Nurse Practitioner	$45.2K	$0
Ashley Gardo	WV	Speech-Language Pathologist	$31.6K	$0
County Of Preston Board Of Health	WV	Public Health & General Preventive Medicine Physician	$5.6K	$10.7K
Jamie Richardson	WV	Certified Registered Nurse Anesthetist	$14.7K	$0

Preston Health Care Services LLC — 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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