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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to 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. 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.

Norton Community Physician Services LLC (NPI 1861674160)

Norton Community Physician Services LLC is a internal medicine physician provider located in Norton, Virginia. This profile covers 0 Medicare and 103 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	Norton Community Physician Services LLC
Address	96 15th St Nw
City	Norton
State	VA
ZIP	24273
Taxonomy	Internal Medicine Physician
NPI Enumerated	November 29, 2007

Payer Source	Total Paid
Medicaid	$6.4M
Medicare	$0

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

103 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…	29,280	$70	$2M
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…	32,360	$50	$1.7M
0241U	N/A	6,010	$120	$726.7K
76830	The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.	2,880	$80	$219.2K
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…	2,560	$80	$199.3K
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…	2,130	$60	$134.4K
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…	1,800	$70	$129.5K
87651	The lab analyst performs a test for the bacteria Streptococcus, group A, using amplified nucleic acid probe technique. Strep A commonly causes acute pharyngitis, or strep throat.	2,750	$30	$93.6K
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…	950	$90	$83.7K
J1050	Injection, medroxyprogesterone acetate, 1 mg	1,030	$80	$83.5K

Showing 1–10 of 103

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Norton Community Physician Services LLC — 5 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

103 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	105	150	300	$420	$381.2K
0241U	N/A	22	90	1,840	$80	$306.3K
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…	76	3,520	370	$70	$280.7K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	90	130	340	$110	$210.5K
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…	87	4,010	290	$50	$199.8K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	12	20	50	$1,790	$184K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	51	140	160	$70	$144.5K
76818	The provider performs a biophysical profile test to measure the health of the baby during pregnancy. The test consists of a nonstress test and an ultrasound.	20	30	300	$60	$136.8K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	27	90	290	$90	$118.5K
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…	117	650	150	$80	$115.4K

Showing 1–10 of 103

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Thomas Whitman	TN	Orthopaedic Surgery Physician	$198.3K	$0
Michael Sanders	KY	Internal Medicine Physician	$150K	$1.6K
John Vance	TN	Surgery Physician	$150.6K	$0
Vishal Raj	CA	Critical Care Medicine (Internal Medicine) Physician	$138.1K	$0
Marta Wayt	TN	Internal Medicine Physician	$118K	$0
Gabriel Hommel	TN	Orthopaedic Surgery Physician	$113.5K	$0
John Phillips	TN	Orthopaedic Surgery Physician	$79.6K	$0
John Mann	VA	Adult Reconstructive Orthopaedic Surgery Physician	$78K	$0
Karen Stallard	VA	Family Nurse Practitioner	$58.1K	$5.3K
David Nauss	VA	Anesthesiology Physician	$10.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Planning District One Behavioral Health Services	VA	Community/Behavioral Health Agency	$0	$28M
Western Virginia Regional Emergency Physicians, LLC	VA	Emergency Medicine Physician	$0	$15.9M
Norton Community Hospital, Inc	VA	General Acute Care Hospital	$0	$8.2M
Med-trans Corporation	VA	Air Ambulance	$255.4K	$488.3K
Orson Go	VA	Cardiovascular Disease Physician	$557.2K	$0
Gary Hubbard	VA	Optometrist	$32.5K	$256.9K
Shipeng Yu	VA	Cardiovascular Disease Physician	$116.9K	$0
April Wallace	VA	Family Nurse Practitioner	$65.2K	$0
Natasha Stanley	VA	Family Nurse Practitioner	$41.8K	$0
Fredia Helbert	VA	Audiologist	$9K	$0

Norton Community Physician Services LLC — Billing Profile & Reimbursement Data

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Norton Community Physician Services LLC — 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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