Providers
BYRON SMITH, D.O.
NPI 1598708307, individual, Princeton, WV, Emergency Medicine
5
Evidence tier
informational
score 31 of 100, rank 10899, $1.5M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | BYRON SMITH, D.O. |
| Type | Individual |
| Status | Active |
| NPI issued | June 13, 2006, last updated November 12, 2007 |
| Practice location | 122 12TH ST, Princeton, WV 24740, 304-487-7000 |
| Mailing address | PO BOX 634715, Cincinnati, OH 45263-0001 |
| Specialties | Emergency Medicine (207P00000X, primary, license 1945 WV) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more | $1.2M | 28% | $97 | $60 (top 5% from $133) | 83rd percentile | |
| 99285 | Emergency department visit with high level of medical decision making | $614K | 14% | $245 | $100 (top 5% from $264) | 94th percentile | |
| 99284 | Emergency department visit with moderate level of medical decision making | $448K | 10% | $172 | $86 (top 5% from $224) | 89th percentile | |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | $391K | 9% | $65 | $44 (top 5% from $110) | 77th percentile | |
| 87426 | Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus | $324K | 7% | $31 | $32 (top 5% from $49) | 50th percentile | |
| 99204 | New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more | $316K | 7% | $114 | $95 (top 5% from $171) | 68th percentile | |
| 87804 | Detection test by immunoassay with direct visual observation for influenza virus | $258K | 6% | $26 | $22 (top 5% from $33) | 69th percentile | |
| 87880 | Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) | $166K | 4% | $14 | $12 (top 5% from $18) | 63rd percentile |
Medicare Part B 2024, largest codes
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 125 | 121 | $16K | $479 | $177 | 2.7x | 6.9x (90th percentile 11.7x) |
| 99284 | Emergency department visit with moderate level of medical decision making | 142 | 138 | $12K | $267 | $121 | 2.2x | 6.7x (90th percentile 11.3x) |
| 99291 | Critical care, first 30-74 minutes | 21 | 21 | $4K | $667 | $213 | 3.1x | 4.7x (90th percentile 10.0x) |
| 99283 | Emergency department visit with low level of medical decision making | 29 | 29 | $1K | $161 | $72 | 2.2x | 5.8x (90th percentile 10.9x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
3 providers in Mercer County, WV carry an indicator in the public record, with $114K at stake between them. The most common is part of a provider network, on 2 of them, followed by more hours than a day holds on 1.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | AMEDISYS WEST VIRGINIA, L.L.C. Bluefield, WV, ranked 3277 | $0 |
|
| 3 | AMEDISYS HOSPICE, L.L.C. Bluefield, WV, ranked 7228 | $0 |
|
| 4 | YUANHUI ZHANG Princeton, WV, ranked 8063 | $114K |
|
Recent enforcement in WV
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJCivil settlementJun 23, 2026
Northern District of West Virginia Part of National Health Care Fraud Takedown Resulting in 455 Defendants Charged in Connection with Over $6.5 Billion in Alleged Fraud
Two providers reached civil settlements resolving allegations that they used pre-signed, invalid prescriptions issued outside the usual course of their professional practice to patients in West Virginia while traveling and not in close proximity to their offices, and in one case submitted claims to Medicare and Medicaid during that time.
DOJComplaint filedJun 23, 2026
U.S. Attorney Moore Capito Announces Fraud Conspiracy Charges Against Sober Living Home Founder and Spouse
Two individuals affiliated with a sober living recovery program allegedly conspired to falsify and submit timesheets to a testing laboratory for drug testing work not performed, and the laboratory paid the billings and obtained reimbursement from federal and state healthcare programs; separately, a sleep laboratory paid $120,000 to resolve allegations it billed Medicaid and the VA Community Health program for sleep studies and polysomnogram reports prepared and signed by unqualified, non-physician staff.
DOJPleaded guiltyJun 17, 2026
Mercer County Woman Pleads Guilty to $175,731.31 Fraud Scheme Targeting Federal Veterans Health Care Benefits
Radford, an owner of Healthcare Therapy Services LLC doing business as Medical Massage Therapy, submitted false bills to CHAMPVA for massage services not rendered, stealing $175,731.31.
DOJCivil settlementMar 5, 2026
Laboratory Agrees to Pay More than $200,000 for Improper Billing to West Virginia Medicaid Program
Integra repeatedly submitted billings to the West Virginia Medicaid program for medically unnecessary testing ordered by medical providers over a two-year period, specifically improper claims for specimen validity testing that were not allowable.
DOJCivil settlementApr 2, 2025
Beckley Medical Clinic and Physician Agree to Pay $152,382.70 to Resolve False Claims Act Allegations
Med-Surg and its owner submitted claims to Medicare and Medicaid using HCPCS code Q3014 for the telehealth originating site facility fee for telehealth visits where the patient was at home, which is not payable.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.