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.

Nicholas Pharmacy Inc (NPI 1962481697)

Field	Value
Entity Type	Organization
Organization	Nicholas Pharmacy Inc
Address	421 Main St
City	Summersville
State	WV
ZIP	26651
Taxonomy	Oxygen Equipment & Supplies (DME)
NPI Enumerated	January 11, 2006

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

19 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	8,750	$120	$1M
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	10,130	$60	$617.9K
A4554	Disposable underpads, all sizes	4,560	$20	$104.8K
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	6,240	$20	$93.6K
E0601	Continuous positive airway pressure (CPAP) device	1,560	$40	$57.8K
E0570	Nebulizer, with compressor	2,710	$20	$54.3K
E0260	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	1,800	$30	$50.4K
A7030	Full face mask used with positive airway pressure device, each	520	$70	$37.1K
E0562	Humidifier, heated, used with positive airway pressure device	1,300	$30	$32.6K
K0001	Standard wheelchair	2,030	$10	$28.4K

Showing 1–10 of 19

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

Nicholas Pharmacy Inc — 0 of 19 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

19 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
A4520	Incontinence garment, any type, (e.g., brief, diaper), each	3	30	2,020	$110	$1.3M
E1390	Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate	22	80	5,550	$60	$504.2K
A4554	Disposable underpads, all sizes	3	20	670	$20	$166.3K
E0601	Continuous positive airway pressure (CPAP) device	29	60	1,500	$40	$71K
E0431	Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing	20	80	3,150	$10	$55.4K
A7030	Full face mask used with positive airway pressure device, each	30	50	560	$60	$52.8K
E0562	Humidifier, heated, used with positive airway pressure device	14	40	820	$30	$38.7K
E0470	Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive…	19	30	170	$80	$25.6K
E0570	Nebulizer, with compressor	13	80	1,100	$20	$24.2K
E0260	Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress	6	50	370	$30	$18.6K

Showing 1–10 of 19

Nearby Providers

Other providers in the same ZIP code as Nicholas Pharmacy Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
West Virginia Health Care Cooperative Inc	WV	Critical Access Hospital	$0	$19.2M
Summersville Pediatrics Inc.	WV	Specialist	$0	$12M
Nicholas Community Action Partnership, Inc.	WV	Point of Service	$0	$6.2M
Summersville Regional Medical Center	WV	Critical Access Hospital	$0	$3.4M
West Virginia Health Care Cooperative Inc	WV	Hospitalist Physician	$0	$3.1M
Nicholas Community Action Partnership, Inc.	WV	Home Health Agency	$0	$2M
Nicholas Emergency Group, PLLC	WV	Emergency Medicine Physician	$0	$1.6M
West Virginia Health Care Cooperative Inc	WV	Rural Health Clinic/Center	$0	$1.6M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.4M
New River Health Association, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$1.3M

Nicholas Pharmacy Inc — Billing Profile & Reimbursement Data

Sign up for Nicholas Pharmacy Inc — Billing Profile & Reimbursement Data policy alerts

Nicholas Pharmacy Inc — Billing Profile & Reimbursement Data

Sign up for Nicholas Pharmacy Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References