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.

William Pugh (NPI 1821289745)

Field	Value
Entity Type	Individual
Organization	William Pugh
Address	200 Wal St
City	Summersville
State	WV
ZIP	26651
Taxonomy	Optometrist
NPI Enumerated	August 6, 2007

Payer Source	Total Paid
Medicare	$30.6K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	160	$70	$10.4K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	110	$50	$5.7K
99204	The provider sees a new 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 provider…	60	$80	$4.6K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	4,390	$1	$4.4K
92250	Code 92250 describes the taking of fundus photographs, that is, photographs of the posterior segment of the inner aspect of the eye, to document alterations in the optic nerve head, retinal vessels,…	160	$20	$3.4K
92083	The provider may use one or more methods to determine the extent of a patient's visual field of one or both eyes; he interprets the results and prepares a report. Report this code for an extended…	70	$40	$2.5K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

William Pugh — 1 of 6 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. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
66984	2	90	210	$70	$60.7K
99214	942	2,740	100	$70	$11.8K
92012	27	80	70	$50	$7.2K
99204	274	1,220	30	$100	$4.1K
92083	50	150	40	$40	$2.9K
92250	23	150	50	$20	$2.1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with William Pugh, 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	$8.2M
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

Nearby Providers

Other providers in the same ZIP code as William Pugh, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Virginia Health Care Cooperative Inc	WV	Critical Access Hospital	$0	$19.2M
Summersville Pediatrics Inc.	WV	Specialist	$0	$12M
Nicholas Community Action Partnership, Inc.	WV	Point of Service	$0	$6.2M
Summersville Regional Medical Center	WV	Critical Access Hospital	$0	$3.4M
West Virginia Health Care Cooperative Inc	WV	Hospitalist Physician	$0	$3.1M
Nicholas Pharmacy Inc	WV	Oxygen Equipment & Supplies (DME)	$0	$2.2M
Nicholas Community Action Partnership, Inc.	WV	Home Health Agency	$0	$2M
Nicholas Emergency Group, PLLC	WV	Emergency Medicine Physician	$0	$1.6M
West Virginia Health Care Cooperative Inc	WV	Rural Health Clinic/Center	$0	$1.6M
Katherine Wooton	WV	Dentist	$0	$1.2M

William Pugh — Billing Profile & Reimbursement Data

Sign up for William Pugh — Billing Profile & Reimbursement Data policy alerts

William Pugh — Billing Profile & Reimbursement Data

Sign up for William Pugh — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References