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.

St Josephs Hospital Of Buckhannon (NPI 1841314473)

St Josephs Hospital Of Buckhannon is a internal medicine physician provider located in Buckhannon, West Virginia. This profile covers 0 Medicare and 61 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	St Josephs Hospital Of Buckhannon
Address	1 Amalia Dr
City	Buckhannon
State	WV
ZIP	26201
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 19, 2007

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

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

61 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	13,860	$90	$1.3M
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…	18,090	$50	$976.9K
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.	12,330	$50	$665.7K
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…	6,480	$80	$485.9K
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…	2,120	$90	$179.9K
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…	1,980	$60	$118.9K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	3,590	$30	$104K
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.	780	$130	$97.8K
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.	2,780	$30	$91.8K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	640	$100	$66.9K

Showing 1–10 of 61

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

St Josephs Hospital Of Buckhannon — 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

61 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.	91	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.	32	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.	37	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…	129	1,270	1,240	$30	$245K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	10	10	1,220	$60	$229.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	120	190	660	$40	$226.4K
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…	141	1,030	890	$50	$221K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	31	80	1,660	$50	$218.3K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	55	60	170	$130	$189.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	33	70	530	$170	$183.7K

Showing 1–10 of 61

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs Hospital Of Buckhannon Inc	WV	Critical Access Hospital	$0	$41.8M
St. Joseph's Hospital Of Buckhannon, Inc.	WV	Rural Health Clinic/Center	$0	$2.2M
St. Joseph's Hospital Of Buckhannon, Inc.	WV	Rural Health Clinic/Center	$0	$1.1M
David Waxman	WV	Adult Reconstructive Orthopaedic Surgery Physician	$163.8K	$0
David Tingler	WV	Cardiovascular Disease Physician	$145.7K	$0
Paul Brager	WV	Hematology & Oncology Physician	$129.5K	$0
David Faber	WV	Surgery Physician	$123.5K	$0
Brian Mcmillan	WV	Ophthalmology Physician	$113.6K	$0
Thomas Mauger	WV	Ophthalmology Physician	$94.8K	$0
Brian Kazienko	WV	Cardiovascular Disease Physician	$86.1K	$7K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central West Virginia Aging Services Inc (hmkr)	WV	Home Health Agency	$0	$61.8M
Central West Virginia Aging Services, Inc. (cm)	WV	Case Management Agency	$0	$8.6M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$6.3M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$5.1M
Drs Martino & Wilson, PLLC	WV	General Practice Dentistry	$0	$4.1M
Upshur County Emergency Medical Services Inc	WV	Land Ambulance	$336.2K	$3.6M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$3.5M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$3M
Community Care Of West Virginia, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$867.3K
Allison Bardes	WV	Ophthalmology Physician	$172.5K	$0

St Josephs Hospital Of Buckhannon — Billing Profile & Reimbursement Data

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St Josephs Hospital Of Buckhannon — 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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