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.

Valley Health Systems Inc (NPI 1194020677)

Field	Value
Entity Type	Organization
Organization	Valley Health Systems Inc
Address	19867 Huntington Road
City	Gallipolis Ferry
State	WV
ZIP	25515
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 14, 2011

Payer Source	Total Paid
Medicaid	$806.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	4,680	$170	$771.4K
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…	2,130	$10	$14.9K
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,…	910	$10	$10K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	180	$40	$6.9K
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…	30	$100	$2.6K
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…	10	$40	$430
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	10	$1	$20
3008F	No Summary found for this code	60	$0	$0
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…	20	$0	$0
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…	50	$0	$0

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

Valley Health Systems Inc — 0 of 7 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	192	390	4,610	$130	$2.2M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	28	30	1,020	$50	$438.2K
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…	522	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…	976	1,030	890	$50	$221K
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…	183	200	490	$30	$57.7K
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,…	182	540	320	$20	$43.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	419	430	200	$10	$18.3K
3008F	No Summary found for this code	109	130	480	$10	$9.1K
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…	351	360	120	$10	$6.5K
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…	74	80	650	$1	$690

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$17.2M
Valley Health Systems, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$14.1M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.4M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.2M
Valley Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$11M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.2M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.1M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$8.6M
Valley Health Systems Inc	WV	Clinical Medical Laboratory	$299.4K	$7M

Valley Health Systems Inc — Billing Profile & Reimbursement Data

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Valley Health Systems 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

Frequently Asked Questions

References