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. Mary's Medical Management, LLC (NPI 1922155217)

St. Mary's Medical Management, LLC is a family medicine physician provider located in Huntington, West Virginia. This profile covers 0 Medicare and 120 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. Mary's Medical Management, LLC
Address	2900 1st Ave
City	Huntington
State	WV
ZIP	25702
Taxonomy	Family Medicine Physician
NPI Enumerated	January 5, 2007

Payer Source	Total Paid
Medicaid	$7.6M
Medicare	$0

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

120 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	54,420	$50	$2.7M
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…	41,800	$50	$2.1M
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	9,190	$30	$303.2K
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…	6,780	$40	$271.3K
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…	3,040	$90	$261.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,850	$110	$194.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,660	$70	$178.5K
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…	2,590	$70	$175.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	3,670	$30	$113.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,060	$90	$98.1K

Showing 1–10 of 120

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. Mary's Medical Management, LLC — 2 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

120 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	21	20	150	$700	$308.2K
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…	25	1,270	1,240	$30	$245K
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…	33	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…	15	1,030	890	$50	$221K
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…	47	60	170	$130	$189.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	51	80	580	$60	$182K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	26	50	730	$60	$126.6K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	25	30	400	$90	$111.5K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	88	140	1,090	$20	$104.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	13	110	170	$100	$103.9K

Showing 1–10 of 120

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rudy Malayil	WV	Interventional Pain Medicine Physician	$295.1K	$0
Timothy Saxe	WV	Internal Medicine Physician	$278.2K	$0
Sanjeev Sharma	WV	Radiation Oncology Physician	$269K	$0
Aamir Cheema	WV	Clinical Cardiac Electrophysiology Physician	$261.6K	$0
Esam Baryun	WV	Cardiovascular Disease Physician	$251K	$0
Vivekanand Neginhal	KY	Orthopaedic Surgery Physician	$250.5K	$0
Tammy Dann	OH	Pain Medicine (Anesthesiology) Physician	$184.1K	$0
Luis Bolano	WV	Orthopaedic Surgery Physician	$177.3K	$0
Steven Lochow	WV	Orthopaedic Surgery Physician	$164.2K	$0
Dwight Saulle	WV	Neurological Surgery Physician	$133K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Mary's Medical Center Inc	WV	General Acute Care Hospital	$0	$47.5M
Huntington Hospitalist Group Inc	WV	Hospitalist Physician	$0	$26M
Allied West Virginia Emergency Physicians PLLC	WV	Emergency Medicine Physician	$0	$8.2M
Valley Health Systems Inc	WV	Clinical Medical Laboratory	$299.4K	$7M
St Mary's Hospitalist Services, LLC	WV	Internal Medicine Physician	$0	$2.5M
Wecare Medical, LLC	WV	Oxygen Equipment & Supplies (DME)	$0	$1.9M
Abbe Education And Staffing, LLC	WV	In Home Supportive Care Agency	$0	$1.2M
Robin Arora	WV	Nephrology Physician	$392.5K	$0
Zahid Iqbal	WV	Internal Medicine Physician	$212.5K	$0
Jarrod Smith	WV	Orthopaedic Surgery Physician	$73.9K	$52.2K

St. Mary's Medical Management, LLC — Billing Profile & Reimbursement Data

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St. Mary's Medical Management, 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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