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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to 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. 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.

Planning District One Behavioral Health Services (NPI 1164588570)

Field	Value
Entity Type	Organization
Organization	Planning District One Behavioral Health Services
Address	1941 Park Ave Sw
City	Norton
State	VA
ZIP	24273
Taxonomy	Community/Behavioral Health Agency
NPI Enumerated	December 29, 2006

Payer Source	Total Paid
Medicaid	$28M
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H0023	Alcohol and/or drug outreach	65,720	$330	$21.6M
T1017	Targeted case management, each 15 minutes	16,140	$310	$5M
T2022	Case management, per month	8,300	$120	$1M
T2023	Targeted case management; per month	1,450	$300	$431.2K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	630	$90	$54.7K
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…	40	$30	$1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	20	$0	$0

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Planning District One Behavioral Health Services — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H0023	Alcohol and/or drug outreach	14	50	33,630	$320	$15M
T1017	Targeted case management, each 15 minutes	32	50	23,860	$330	$9.4M
T2023	Targeted case management; per month	32	40	3,000	$300	$1.3M
T2022	Case management, per month	22	60	6,000	$130	$1M
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	23	50	470	$190	$207.4K
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…	3,301	4,010	290	$50	$199.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	653	660	310	$60	$110.9K

Nearby Providers

Other providers in the same ZIP code as Planning District One Behavioral Health Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Virginia Regional Emergency Physicians, LLC	VA	Emergency Medicine Physician	$0	$15.9M
Norton Community Hospital, Inc	VA	General Acute Care Hospital	$0	$8.2M
Norton Community Physician Services LLC	VA	Internal Medicine Physician	$0	$6.4M
Med-trans Corporation	VA	Air Ambulance	$255.4K	$488.3K
Orson Go	VA	Cardiovascular Disease Physician	$557.2K	$0
Gary Hubbard	VA	Optometrist	$32.5K	$256.9K
Shipeng Yu	VA	Cardiovascular Disease Physician	$116.9K	$0
April Wallace	VA	Family Nurse Practitioner	$65.2K	$0
Natasha Stanley	VA	Family Nurse Practitioner	$41.8K	$0
David Nauss	VA	Anesthesiology Physician	$10.9K	$0

Planning District One Behavioral Health Services — Billing Profile & Reimbursement Data

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Planning District One Behavioral Health Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References