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.

Matthew Wilson (NPI 1891726295)

Field	Value
Entity Type	Individual
Organization	Matthew Wilson
Address	1001 20th St
City	Huntington
State	WV
ZIP	25703
Taxonomy	Allergy Physician
NPI Enumerated	July 5, 2006

Payer Source	Total Paid
Medicare	$578.9K
Medicaid	$0

Key Findings

This provider’s payment mix is effectively single-payer Medicare: lifetime Medicare revenue is $578.9K and there is no Medicaid billing on file. That concentration means the practice’s financial performance is driven by Medicare reimbursement and usage patterns rather than a dual-payer Medicaid/Medicare mix.

Revenue is highly concentrated in a small set of services: the top three Medicare codes account for 85.3% of total Medicare revenue, with J2182 alone representing $414K (71.2% of Medicare revenue). This concentration indicates that changes in coverage or reimbursement for those specific codes would have outsized impact on the provider’s revenue.

The code mix identifies a procedure-oriented allergy/immunology practice that combines biologic drug administration with allergen immunotherapy and skin testing: J2182 (mepolizumab injection) dominates revenue, while 95165, 95115, 95004 and 95024 show large volumes of antigen preparation, immunotherapy injections, and skin testing. Together these codes imply on-site medication administration and a robust immunotherapy workflow rather than a pure outpatient E/M clinic.

Operationally the practice appears set up for high-volume medication and injection delivery: J2182 has 18K claims, 95165 has 4.7K claims, 95115 has 3.2K claims, and the general injection code 96372 has 548 claims; 96372 is labeled "notably above typical" (98th percentile). These volumes point to recurring, scheduled administrations and supporting nursing or infusion capacity to manage injections and biologic therapy.

Competitive standing is mixed by code: for the principal biologic J2182 the provider ranks #17 of 187 nationally (91st percentile) but the dataset labels that volume as "typical, unremarkable" for this code, indicating a relatively high rank within a small national cohort yet not outside expected norms. By contrast, 95115 ranks #8 of 1822 providers (100th percentile, described as an "extreme outlier, far above typical national volume"), signaling that the provider is a national outlier for allergen immunotherapy injections.

Office visit (E/M) activity supports the procedural work but is not the primary revenue driver: 99214 generated $35K (6.0% of Medicare revenue) across 417 claims and ranks #65098 of 479517 providers (86th percentile), while 99213 contributed $10.6K across 177 claims (75th percentile). This pattern suggests regular evaluation-and-management visits are performed in conjunction with procedure-based services rather than driving the practice’s revenue.

The practice integrates diagnostic respiratory testing alongside allergy services: codes such as 94375 (337 claims, $8.4K, 93th percentile), 95012 (331 claims, $4K, labeled "notably above typical" at the 98th percentile), and 94060 (17 claims) show routine use of pulmonary function and FeNO testing. High percentiles on 95012 and 94375 indicate the provider performs more airway inflammation and flow-volume testing than most peers, supporting management of asthma and related conditions.

The provider’s NPI was enumerated on 2006-07-05 (~20 years ago), indicating long-standing Medicare participation. This tenure combined with concentrated, procedure-heavy billing suggests established clinical workflows and referral relationships anchored around biologic administration and immunotherapy services.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J2182	Injection, mepolizumab, 1 mg	18,000	$20	$414K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	4,730	$10	$47.3K
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…	420	$80	$35K
95115	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives a single injection during the visit.	3,240	$10	$19.4K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	5,550	$1	$16.6K
95024	The provider introduces allergenic extracts into the skin to determine if the patient has an immediate allergic response, interprets the results and writes a report specifying the number of tests.	1,930	$10	$11.6K
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…	180	$60	$10.6K
94375	The provider performs a respiratory flow volume loop study to differentiate a patient's obstructive pulmonary disorder from restrictive pulmonary disorders. He may also use the procedure to…	340	$30	$8.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	550	$10	$5.5K
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…	50	$110	$5.4K

Showing 1–10 of 16

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. West Virginia Distribution

Matthew Wilson — 5 of 16 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. state median

16 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2182	1	10	18,000	$20	$413.8K
95165	3	20	700	$10	$17.6K
99214	254	2,740	100	$70	$11.8K
99213	722	2,860	80	$50	$7.5K
95004	2	10	1,200	$1	$5.7K
99204	325	1,220	30	$100	$4.1K
95024	1	10	440	$10	$3.6K
95115	1	10	180	$10	$3.5K
94375	1	10	20	$30	$3.1K
95012	1	10	170	$10	$2.1K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Matthew Wilson, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tri-state Allergy, Inc	WV	Allergy Physician	$0	$1.8M
Sriharsha Velury	OH	Cardiovascular Disease Physician	$211.9K	$0
Carter Gussler	KY	Ophthalmology Physician	$146.3K	$11.9K

Nearby Providers

Other providers in the same ZIP code as Matthew Wilson, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ohio Valley Physicians Inc	WV	Family Medicine Physician	$0	$43M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$17.2M
University Physicians & Surgeons, Inc.	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$9.4M
Recovery Resource Group	WV	Community/Behavioral Health Agency	$0	$8.5M
Valley Health Systems Inc	WV	General Practice Physician	$0	$4.7M
Valley Health Systems, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$3.8M
Valley Health Systems Inc	WV	Obstetrics & Gynecology Physician	$0	$1M
Contemplations Behavioral Health Services	WV	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$919.6K
Huntington Physical Therapy Services Inc	WV	Physical Therapist	$0	$843K
Joseph De Lapa	WV	Pain Medicine (Anesthesiology) Physician	$105.5K	$0

Matthew Wilson — Billing Profile & Reimbursement Data

Sign up for Matthew Wilson — Billing Profile & Reimbursement Data policy alerts

Matthew Wilson — Billing Profile & Reimbursement Data

Sign up for Matthew Wilson — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References