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.

Pleasant Valley Hospital Inc (NPI 1083274385)

Field	Value
Entity Type	Organization
Organization	Pleasant Valley Hospital Inc
Address	2007 2nd St
City	Mason
State	WV
ZIP	25260
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	June 18, 2019

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	6,620	$130	$860.6K
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…	2,080	$40	$89.5K
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…	1,630	$30	$47.2K
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,…	200	$50	$9.8K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	200	$10	$1K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	700	$1	$700
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	80	$1	$330
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	70	$1	$270
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	20	$0	$0
99441	N/A	60	$0	$0

Showing 1–10 of 11

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

Pleasant Valley Hospital Inc — 0 of 8 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

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	168	390	4,610	$130	$2.2M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	161	160	3,690	$80	$714.8K
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…	581	1,270	1,240	$30	$245K
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…	350	1,030	890	$50	$221K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	171	330	790	$10	$64.1K
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,…	309	540	320	$20	$43.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	94	190	190	$30	$35.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	274	430	200	$10	$18.3K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	214	360	120	$10	$6.5K
99442	N/A	46	80	50	$10	$3.5K

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pleasant Valley Hospital Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pleasant Valley Hospital, Inc.	WV	Rural Health Clinic/Center	$0	$6.6M
Pleasant Valley Hospital, Inc.	WV	General Acute Care Hospital	$0	$6.6M
Point Pleasant Physician Billing Services	WV	Multi-Specialty Clinic/Center	$0	$2.2M
Michael Collins	WV	Nephrology Physician	$245.3K	$0
Wesam Frandah	WV	Gastroenterology Physician	$139K	$0
Ahmed Sherif	WV	Gastroenterology Physician	$88.4K	$0
Pramod Pantangi	WV	Gastroenterology Physician	$41.3K	$0
Haitam Buaisha	IN	Gastroenterology Physician	$38.2K	$0
Tejas Joshi	WV	Hepatology Physician	$31.9K	$0
Shrikant Vaidya	WV	Urology Physician	$19.7K	$20

Nearby Providers

Other providers in the same ZIP code as Pleasant Valley Hospital Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danny Westmoreland	WV	Family Medicine Physician	$67.9K	$326.3K
Wal-mart Stores East LP	WV	Community/Retail Pharmacy	$48K	$90

Pleasant Valley Hospital Inc — Billing Profile & Reimbursement Data

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Pleasant Valley Hospital Inc — 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