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

Why is the Medicaid comparison limited to Kentucky 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. Kentucky (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.

North Fork Valley Community Health Board, Inc. (NPI 1164594511)

Field	Value
Entity Type	Organization
Organization	North Fork Valley Community Health Board, Inc.
Address	750 Morton Blvd
City	Hazard
State	KY
ZIP	41701
Taxonomy	Family Medicine Physician
NPI Enumerated	November 14, 2006

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

58 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	21,350	$50	$1.1M
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…	19,580	$40	$685.2K
D1120	Prophylaxis–child	7,690	$40	$315.2K
D0150	Comprehensive oral evaluation – new or established patient	10,640	$20	$255.4K
D1351	Sealant - per tooth	14,680	$10	$190.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	14,260	$10	$156.8K
90832	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…	2,650	$40	$113.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	8,620	$10	$103.4K
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…	1,200	$50	$61.3K
D0140	Limited oral evaluation – problem focused	1,180	$40	$44.6K

Showing 1–10 of 58

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

North Fork Valley Community Health Board, Inc. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

58 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	50	70	310	$100	$495.2K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	995	1,270	760	$80	$447.2K
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…	340	3,340	1,020	$30	$296K
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…	102	2,460	580	$40	$245K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	53	60	530	$100	$234.4K
90832	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…	161	600	600	$40	$207.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	192	260	540	$70	$176.6K
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…	140	500	250	$60	$152.8K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	8	40	6,320	$10	$131.4K
D1120	Prophylaxis–child	51	770	500	$50	$127.1K

Showing 1–10 of 58

Related Providers

Other providers that share a Tax Identification Number (TIN) with North Fork Valley Community Health Board, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky Medical Services Foundation, Inc	KY	Internal Medicine Physician	$0	$110.4M
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
Kentucky Medical Services Foundation	KY	Nurse Practitioner	$0	$12.5M
Kyle Thompson	ID	Retina Specialist (Ophthalmology) Physician	$4.5M	$0
Matthew Cole	TN	Ophthalmology Physician	$3.3M	$0
Kentucky Medical Services Foundation	KY	Clinical Pathology/Laboratory Medicine Physician	$0	$3M
Gregory Lee	GA	Ophthalmology Physician	$2.9M	$6.3K
Shivani Reddy	IN	Ophthalmology Physician	$2.4M	$0
Mark Kleinman	TN	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Cheryl Lee	WA	Ophthalmology Physician	$1.5M	$0

Nearby Providers

Other providers in the same ZIP code as North Fork Valley Community Health Board, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kentucky River Community Care, Inc	KY	Specialist	$0	$109.1M
Appalachian Regional Healthcare, Inc.	KY	General Acute Care Hospital	$0	$107.9M
Kentucky River Community Care, Inc	KY	Mental Health Counselor	$0	$104M
Kentucky River Area Dev Dist	KY	Supports Brokerage Agency	$0	$43.4M
Primary Care Centers Of Eastern Kentucky, LLC	KY	Rural Health Clinic/Center	$0	$26.2M
Soaring Potentials Lllp	KY	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$20.4M
Bhg Xxvi, LLC	KY	Substance Use Disorder Rehabilitation Clinic/Center	$493.7K	$16.1M
Southern Medical Partners, LLC	KY	Emergency Medicine Physician	$0	$15.6M
Dungarvin Kentucky, LLC - Hazard	KY	Developmentally Disabled Services Day Training Agency	$0	$10.1M
Quantum Healthcare Associates Inc	KY	General Practice Physician	$0	$9.1M

North Fork Valley Community Health Board, Inc. — Billing Profile & Reimbursement Data

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North Fork Valley Community Health Board, 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