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.

Radiological Physician Associates Inc (NPI 1811996960)

Radiological Physician Associates Inc is a diagnostic radiology physician provider located in Fairmont, West Virginia. This profile covers 0 Medicare and 144 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	Radiological Physician Associates Inc
Address	700 Village Dr
City	Fairmont
State	WV
ZIP	26554
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	July 20, 2005

Payer Source	Total Paid
Medicaid	$11.1M
Medicare	$0

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

144 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	28,820	$70	$1.9M
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.	28,280	$60	$1.8M
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.	35,600	$30	$996.8K
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…	72,870	$10	$655.9K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	112,570	$10	$562.9K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	17,400	$30	$452.5K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	6,890	$50	$358.4K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	5,920	$40	$260.3K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	11,370	$20	$238.8K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	10,880	$20	$195.9K

Showing 1–10 of 144

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

Radiological Physician Associates Inc — 22 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

144 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	2	80	950	$140	$559.5K
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.	2	80	1,410	$120	$332.8K
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.	3	90	1,380	$60	$273.2K
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	7	30	480	$170	$210.4K
78815	PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.…	9	20	340	$380	$202.9K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	62	60	330	$210	$151.7K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	3	50	370	$100	$148.6K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	4	100	3,310	$10	$140.7K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	3	50	470	$100	$135.7K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	14	50	730	$60	$126.6K

Showing 1–10 of 144

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Monongahela Valley Association Of Health Centers, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$16.6M
Alecto Healthcare Services Fairmont LLC	WV	General Acute Care Hospital	$0	$11.7M
Bbc Rehab, Pc,inc	WV	Substance Use Disorder Rehabilitation Clinic/Center	$0	$10.5M
Bioscrip Infusion Services, LLC	WV	Home Infusion Therapy Pharmacy	$0	$8.8M
Marion County Rescue Squad Inc	WV	Land Ambulance	$833K	$7.6M
Family Service Of Marion & Harrison Counties Inc	WV	Community/Behavioral Health Agency	$0	$5.5M
Essential Needs Homecare	WV	In Home Supportive Care Agency	$0	$4.7M
Yale Academy LLC	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.8M
Youth Academy, LLC	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.8M
Yore Academy, Inc.	WV	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$3.8M

Radiological Physician Associates Inc — Billing Profile & Reimbursement Data

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Radiological Physician Associates 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

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mark Lisle	WV	Diagnostic Radiology Physician	$150.1K	$710
Joseph Migaiolo	WV	Diagnostic Radiology Physician	$140.7K	$0
James Flannery	OH	Diagnostic Radiology Physician	$140.4K	$0
Frederick Gabriele	WV	Diagnostic Radiology Physician	$125.8K	$0
Jason Deberry	VA	Diagnostic Radiology Physician	$121.9K	$0
Mark Hackney	WV	Diagnostic Radiology Physician	$120.8K	$0
Cory Smith	WV	Diagnostic Radiology Physician	$119.8K	$0
Thomas Koay	WV	Diagnostic Radiology Physician	$119.3K	$0
Wesley Tuel	PA	Diagnostic Radiology Physician	$109.6K	$0
Patrick Brown	WV	Student in an Organized Health Care Education/Training Program	$106.5K	$0