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.

Jefferson Memorial Hospital (NPI 1891722377)

Key Findings

Field	Value
Entity Type	Organization
Organization	Jefferson Memorial Hospital
Address	300 S. Preston Street
City	Ranson
State	WV
ZIP	25438
Taxonomy	Critical Access Hospital
NPI Enumerated	June 28, 2006

Payer Source	Total Paid
Medicaid	$21.6M
Medicare	$0

JEFFERSON MEMORIAL HOSPITAL is effectively a single‑payer facility in the claims on file: there is no Medicare billing on record and all reported federal fee‑for‑service revenue is from Medicaid, totaling $21.6M. This concentration means Medicaid reimbursement dynamics will drive most payer negotiations and utilization patterns for this provider.

Revenue concentration is notable at the code level: the top three Medicaid codes (99284, 74177, 99283) account for 31.9% of the provider's total Medicaid revenue. Those top codes individually generate $1.8M (99284, 11.9%), $1.7M (74177, 10.8%), and $1.4M (99283, 9.2%) respectively, indicating a small set of services produce a large share of Medicaid dollars.

The code mix points to an ED‑centric acute care operation with substantial imaging and laboratory support: the highest‑revenue codes are emergency department E/M visits (99284, 99283, 99285) alongside high‑revenue CT imaging codes such as 74177 ($1.7M, 10.8%) and 74176 ($806.4K, 5.2%). Combined with frequent lab testing and drug screens, this pattern is consistent with a rural critical access hospital providing emergency evaluation, imaging, and inpatient/observation care.

Competitive standing within the state is generally modest to typical: ED visit codes appear in upper percentiles but are described as "typical, unremarkable volume"—for example 99283 ranks #24 of 163 providers (86th percentile) and 99284 ranks #30 of 168 (83th percentile). These placements suggest JEFFERSON MEMORIAL is not a statewide outlier dominating ED volumes, but it does occupy a steady, above‑median position among peers rather than a niche or rare-volume provider.

Laboratory and testing are sizable ancillary revenue streams that support the hospital’s acute services. High-volume lab codes include 80053 ($964.7K, 6.2%, rank #21 of 111, 82th percentile), 85025 ($861.2K, 5.5%, rank #19 of 138, 87th percentile), 80307 ($806K, 5.2%, rank #30 of 106, 72th percentile), and definitive drug testing G0480 ($245.4K, 1.6%, rank #15 of 54, 74th percentile), indicating in‑house lab capacity for routine chemistry, hematology, toxicology, and confirmatory testing.

Imaging capability extends beyond abdomen/pelvis CT to include head CT and CTA chest at moderate volumes: 70450 produced $533.4K (3.4%, rank #35 of 90, 62th percentile) while 71275 produced $257.4K (1.7%, rank #27 of 53, 50th percentile). These figures reinforce the clinical profile of a community hospital providing timely CT imaging to support ED workups and acute diagnostics.

IV administration and infusion services are a recurring revenue component tied to ED/inpatient care: 96374 generated $638.8K (4.1%, rank #17 of 61, 73th percentile), 96361 $566.1K (3.6%, rank #15 of 53, 73th percentile), 96365 $395.9K (2.5%, rank #19 of 58, 68th percentile), and 96375 $331.5K (2.1%, rank #20 of 62, 69th percentile). The aggregate presence of these codes indicates routine use of IV medications and fluids as part of the hospital’s acute treatment pathways.

The provider has an established local footprint, with its NPI enumerated on 2006-06-28 (~20 years ago) and taxonomy listed as Critical Access Hospital. That tenure plus the CAH designation aligns with a stable rural hospital role—serving emergency and diagnostic needs regionally while depending heavily on Medicaid revenue flows rather than Medicare reimbursement.

Medicaid: Complete Services Breakdown

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

202 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.	14,880	$120	$1.8M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	2,420	$690	$1.7M
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.	15,850	$90	$1.4M
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.	7,730	$150	$1.2M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	28,370	$30	$964.7K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	29,700	$30	$861.2K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,440	$560	$806.4K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	7,900	$100	$806K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7,890	$80	$638.8K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	4,970	$110	$566.1K

Showing 1–10 of 202

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

Jefferson Memorial Hospital — 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

202 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	4	10	230	$40	$1.9M
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.	29	130	2,090	$210	$1.5M
87661	The lab analyst performs a test for Trichomonas vaginalis using nucleic acid amplified probe technique.	7	20	270	$20	$1.5M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	14	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	14	40	820	$30	$1.2M
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.	30	170	3,350	$120	$1.1M
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	12	20	70	$20	$832.7K
87624	The lab analyst performs a test to determine the presence of human papillomavirus, or HPV. The provider uses nucleic acid detection for high–risk types and produces a pooled result.	7	20	720	$20	$721.7K
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.	24	160	3,690	$80	$714.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	26	80	950	$140	$559.5K

Showing 1–10 of 202

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Reynolds Memorial Hospital, Inc	WV	Emergency Medical Services (Emergency Medicine) Physician	$0	$11.4M
City Hospital, Inc.	WV	Internal Medicine Physician	$0	$1.9M
Jefferson Memorial Hospital	WV	Internal Medicine Physician	$0	$941.1K
Walid Gharib	WV	Cardiovascular Disease Physician	$131.2K	$0
Saroj Neupane	MI	Internal Medicine Physician	$118K	$0
Ali Amjad	PA	Hematology & Oncology Physician	$98K	$2.5K
Brian Kazienko	WV	Cardiovascular Disease Physician	$86.1K	$7K
Alison Bailey	GA	Advanced Heart Failure and Transplant Cardiology Physician	$91.4K	$0
Michael Londner	VA	Emergency Medicine Physician	$89.2K	$0
Brandon Wilson	WV	General Practice Physician	$62.3K	$6.4K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
East Mountain Health Physicians, Inc.	WV	Urgent Care Clinic/Center	$0	$5.1M
Jmh Emergency Physicians	WV	Emergency Medicine Physician	$0	$2.6M
Jefferson Pharmacy Inc	WV	Pharmacy	$13.8K	$2.1M
Jefferson County Council On Aging	WV	Home Health Agency	$0	$1.5M
Jefferson County Emergency Services Agency	WV	Land Ambulance	$336.8K	$638.2K
Gagan Singh	WV	Ophthalmology Physician	$449K	$0
Said Sana	WV	Family Medicine Physician	$424.4K	$0
Eric Ingersoll	WV	Orthopaedic Surgery Physician	$18.1K	$69.8K
Alton Temple	WV	Emergency Medicine Physician	$81K	$700
Erin Butcho	WV	Diagnostic Radiology Physician	$52K	$6.2K

Jefferson Memorial Hospital — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References