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

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

West Valley Medical Associates Inc (NPI 1164936720)

West Valley Medical Associates Inc is a internal medicine physician provider located in Caldwell, Idaho. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	West Valley Medical Associates Inc
Address	1717 Arlington Ave
City	Caldwell
State	ID
ZIP	83605
Taxonomy	Internal Medicine Physician
NPI Enumerated	November 18, 2017

Payer Source	Total Paid
Medicaid	$345.9K
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,130	$120	$130.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	1,270	$70	$82.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,430	$40	$52.9K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	510	$60	$31.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	310	$80	$24.3K
99220	N/A	90	$100	$9.6K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	30	$150	$4K
99204	The provider sees a new 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 provider…	30	$100	$2.7K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	20	$150	$2.5K
99203	The provider sees a new 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 provider…	30	$80	$2.1K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

West Valley Medical Associates Inc — 1 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	605	670	740	$40	$193.6K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8	20	200	$90	$158.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	30	60	1,370	$50	$151.3K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	7	10	20	$340	$94.9K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	29	40	180	$170	$75K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20	40	480	$60	$71.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	7	40	300	$120	$66.3K
99203	The provider sees a new 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 provider…	162	220	90	$80	$51.4K
99204	The provider sees a new 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 provider…	124	180	70	$110	$45.6K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	7	10	30	$60	$31K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Starr	ID	Family Medicine Physician	$112.1K	$0
Curtis Coulam	ID	Diagnostic Radiology Physician	$104.3K	$0
Jared Chugg	ID	Diagnostic Radiology Physician	$78.9K	$0
Nathan Holmes	ID	Internal Medicine Physician	$68.4K	$0
Cyle Goodman	ID	Diagnostic Radiology Physician	$63.4K	$0
Matt Moore	ID	Diagnostic Radiology Physician	$57.2K	$0
Carolyn Punt	ID	Gerontology Nurse Practitioner	$9.7K	$0
Cody Gardner	ID	Certified Registered Nurse Anesthetist	$7.9K	$0
Michael Garbett	ID	Certified Registered Nurse Anesthetist	$7.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Alphonsus Regional Medical Center Inc	ID	Family Medicine Physician	$0	$32.6M
Saint Alphonsus Regional Medical Center Inc	ID	Rural Health Clinic/Center	$0	$9.9M
Human Supports Of Idaho	ID	General Practice Physician	$0	$9.4M
County Of Canyon Canyon Co School Dist 132	ID	Local Education Agency (LEA)	$0	$8.3M
West Valley Medical Center, Inc.	ID	General Acute Care Hospital	$0	$7.8M
Carepoint Health Emergency Medicine Idaho, PLLC	ID	Emergency Medicine Physician	$0	$4.3M
Mana Resources LLC	ID	Community/Behavioral Health Agency	$0	$3.1M
Family Eyecare Specialists PLLC	ID	Optometrist	$0	$2.9M
Hope House, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$2.4M
West Valley Medical Group LLC	ID	Internal Medicine Physician	$0	$2.1M

West Valley Medical Associates Inc — Billing Profile & Reimbursement Data

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West Valley Medical Associates 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

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