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.

Robin Darnell PLLC (NPI 1831494376)

Robin Darnell PLLC is a pediatric adolescent medicine physician provider located in Charleston, West Virginia. This profile covers 0 Medicare and 36 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	Robin Darnell PLLC
Address	4502 Maccorkle Ave Se Ste B
City	Charleston
State	WV
ZIP	25304
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	January 13, 2011

Payer Source	Total Paid
Medicaid	$990.1K
Medicare	$0

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

36 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…	3,820	$70	$274.9K
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…	3,350	$50	$164.3K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,550	$90	$133K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,410	$80	$110.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,130	$80	$91.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	480	$90	$42.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,820	$10	$38.2K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	1,460	$30	$36.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2,010	$20	$32.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	1,130	$20	$16.9K

Showing 1–10 of 36

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

Robin Darnell PLLC — 0 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

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	425	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…	223	1,030	890	$50	$221K
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…	210	340	140	$90	$97.5K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	32	150	520	$50	$76.2K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	36	140	550	$50	$67.2K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	185	330	790	$10	$64.1K
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,…	479	540	320	$20	$43.2K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	38	190	220	$50	$42.7K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	77	90	330	$40	$41.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	40	200	360	$20	$26K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Healthteam Critical Care Transport LLC	WV	Land Ambulance	$2.5M	$19.8M
Cabin Creek Health Center, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$8.2M
Holistic, Inc	WV	Family Medicine Physician	$0	$8M
Valley Health Systems, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$7.1M
Imad Shammaa	WV	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$5.2M
Summit Bhc West Virginia LLC	WV	Substance Use Disorder Rehabilitation Hospital Unit	$0	$5.1M
General Anesthesia Services Inc	WV	Anesthesiology Physician	$0	$4.3M
Neurology & Headache Clinic PLLC	WV	Neurology Physician	$0	$3.8M
Bioscrip Infusion Services, LLC	WV	Home Infusion Therapy Pharmacy	$0	$3.3M
Don E. Skaff, Dds, Inc.	WV	Pediatric Dentistry	$0	$2M

Robin Darnell PLLC — Billing Profile & Reimbursement Data

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Robin Darnell PLLC — 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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