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 Memorial Hospital Corporation (NPI 1841230661)

Preston Memorial Hospital Corporation is a emergency medicine physician provider located in Kingwood, West Virginia. This profile covers 0 Medicare and 51 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 Memorial Hospital Corporation
Address	150 Memorial Dr
City	Kingwood
State	WV
ZIP	26537
Taxonomy	Emergency Medicine Physician
NPI Enumerated	June 8, 2006

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

51 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…	12,950	$70	$893.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	4,650	$110	$507.1K
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…	11,620	$40	$499.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	6,090	$60	$353.3K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	430	$150	$64.8K
99384	The provider performs a well–patient visit for an adolescent who is between the ages of 12 and 17 who meets the definition of new patient.	830	$70	$56.7K
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…	680	$80	$55.4K
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…	970	$50	$48.4K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	1,200	$30	$36K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	330	$50	$17.1K

Showing 1–10 of 51

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 Memorial Hospital Corporation — 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

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	104	130	2,090	$210	$1.5M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	69	170	3,350	$120	$1.1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	57	160	3,690	$80	$714.8K
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…	197	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…	72	1,030	890	$50	$221K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	50	100	1,200	$50	$135.9K
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…	63	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…	101	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…	121	140	550	$50	$67.2K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	256	330	790	$10	$64.1K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Preston Memorial Hospital Corporation	WV	Critical Access Hospital	$0	$20.2M
Eric Johnson	KY	Diagnostic Radiology Physician	$78.6K	$3.1M
Concord Hospital, Inc.	NH	Emergency Medicine Physician	$0	$2.5M
City Hospital, Inc.	WV	Internal Medicine Physician	$0	$1.9M
Adnan Alghadban	WV	Neurology Physician	$533K	$0
John Pappas	MD	Vascular & Interventional Radiology Physician	$487.8K	$17.2K
Zaid Abed Al-qudah	WV	Clinical Neurophysiology Physician	$380.4K	$0
James Benjamin	MD	Diagnostic Radiology Physician	$250.1K	$0
Lowell Larew	WV	Medical Physician Assistant	$193.2K	$0
Surendra Pawar	PA	Diagnostic Radiology Physician	$157.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Preston Health Care Services LLC	WV	Family Health Clinical Nurse Specialist	$0	$3M
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
Robin Goodwin	WV	Family Nurse Practitioner	$21.6K	$0
Courtney Swisher	WV	Family Nurse Practitioner	$21.3K	$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 Memorial Hospital Corporation — 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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