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.

New River Health Association, Inc. (NPI 1811983331)

Field	Value
Entity Type	Organization
Organization	New River Health Association, Inc.
Address	908 Scarbro Road
City	Scarbro
State	WV
ZIP	25917
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 20, 2005

Payer Source	Total Paid
Medicaid	$8.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

78 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	58,530	$110	$6.7M
D0999	N/A	3,530	$160	$553.6K
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…	28,890	$20	$433.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	4,780	$20	$86.1K
90832	In 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…	5,480	$10	$71.3K
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,…	9,380	$10	$56.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	4,520	$10	$45.2K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	3,970	$10	$43.6K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	2,090	$20	$33.4K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	1,720	$10	$24.1K

Showing 1–10 of 78

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

New River Health Association, Inc. — 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

78 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	30	390	4,610	$130	$2.2M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	98	110	2,080	$50	$537.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	64	110	5,530	$20	$344.8K
D0999	N/A	3	20	500	$140	$317.9K
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…	74	1,270	1,240	$30	$245K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	63	140	3,080	$20	$243.1K
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…	421	1,030	890	$50	$221K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	74	80	2,960	$20	$198.8K
90837	In 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…	280	310	740	$80	$178.2K
84443	The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…	54	100	2,470	$20	$130K

Showing 1–10 of 78

Related Providers

Other providers that share a Tax Identification Number (TIN) with New River Health Association, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
New River Health Association, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$1.9M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.5M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.4M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.3M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.2M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.1M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1M
Jawad Zafar	WV	Psychiatry Physician	$46.1K	$4.8K

New River Health Association, Inc. — Billing Profile & Reimbursement Data

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New River Health Association, 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

Related Providers

Frequently Asked Questions

References