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 Hospitalist Services, LLC (NPI 1942432687)

Field	Value
Entity Type	Organization
Organization	St Mary's Hospitalist Services, LLC
Address	2900 1st Ave Rm 1025
City	Huntington
State	WV
ZIP	25702
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 13, 2009

Payer Source	Total Paid
Medicaid	$2.5M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	34,660	$30	$1.2M
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…	5,420	$80	$406.5K
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…	7,960	$50	$398.2K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	3,180	$60	$184.4K
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…	1,790	$70	$123.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	1,430	$30	$47.1K
99220	N/A	510	$90	$44K
4040F	Pneumococcal vaccine triggers the immune response of the patient and protects against infection from pneumococcus bacteria, an infectious organism. The provider administers the vaccine to all…	3,190	$10	$28.7K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	3,070	$10	$27.7K
99225	N/A	550	$40	$22.4K

Showing 1–10 of 20

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 Hospitalist Services, LLC — 1 of 20 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	8	190	660	$40	$226.4K
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…	7	80	580	$60	$182K
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…	7	110	170	$100	$103.9K
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…	24	130	200	$70	$82.4K
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…	58	90	200	$30	$78.8K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	6	60	160	$60	$67.5K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	15	90	250	$50	$55.5K
99220	N/A	4	20	130	$120	$36.7K
99219	N/A	9	30	80	$70	$18.2K
99225	N/A	4	20	230	$40	$15.2K

Showing 1–10 of 20

Related Providers

Other providers that share a Tax Identification Number (TIN) with St Mary's Hospitalist Services, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Radhakrishna Kukkillaya	WV	Internal Medicine Physician	$164.4K	$0
Gilbert Garza	WV	Internal Medicine Physician	$110.6K	$0
Staci Smith	OH	Nephrology Physician	$109K	$0
Sanjay Suwal	WV	Internal Medicine Physician	$108.1K	$0
Matthew Werthammer	WV	Neurological Surgery Physician	$104.1K	$0
Kenneth Pearson	WV	Family Medicine Physician	$101.2K	$0
Maegen Brennan	WV	Family Nurse Practitioner	$84.5K	$0
Joseph Barbera	WV	Internal Medicine Physician	$65.1K	$0

Nearby Providers

Other providers in the same ZIP code as St Mary's Hospitalist Services, LLC, ranked by combined Medicare and Medicaid revenue.

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
St. Mary's Medical Management, LLC	WV	Family Medicine Physician	$0	$7.6M
Valley Health Systems Inc	WV	Clinical Medical Laboratory	$299.4K	$7M
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
Rudy Malayil	WV	Interventional Pain Medicine Physician	$295.1K	$0
Sanjeev Sharma	WV	Radiation Oncology Physician	$269K	$0

St Mary's Hospitalist Services, LLC — Billing Profile & Reimbursement Data

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St Mary's Hospitalist 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

Related Providers

Nearby Providers

Frequently Asked Questions

References