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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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-wide Health Systems, Inc (NPI 1225025703)

Valley-wide Health Systems, Inc is a federally qualified health center (fqhc) provider located in La Junta, Colorado. This profile covers 0 Medicare and 60 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	Valley-wide Health Systems, Inc
Address	1012 Belmont Avenue
City	La Junta
State	CO
ZIP	81050
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	September 30, 2005

Payer Source	Total Paid
Medicaid	$16.2M
Medicare	$0

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

60 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	45,760	$210	$9.5M
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…	16,940	$190	$3.3M
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,…	6,510	$240	$1.5M
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…	1,700	$250	$420.4K
99391	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…	1,400	$250	$351.4K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,130	$210	$232.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	850	$250	$208.1K
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…	920	$200	$185.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	7,010	$30	$175.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	250	$210	$52.8K

Showing 1–10 of 60

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Valley-wide Health Systems, Inc — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

60 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	136	150	2,140	$260	$2M
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…	37	2,520	330	$100	$352K
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…	108	2,630	430	$90	$268.2K
99391	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…	76	240	550	$110	$208.5K
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…	67	260	380	$100	$161.6K
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…	214	260	280	$40	$123.2K
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,…	26	690	140	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	70	290	160	$110	$111.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	287	720	130	$100	$110K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	90	100	380	$20	$107.6K

Showing 1–10 of 60

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southeast Mental Health Services	CO	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$17.1M
Inspiration Field	CO	Case Management Agency	$0	$16.4M
Ark-valley Home & Health Care Services, LLC	CO	Home Health Agency	$0	$11.5M
Arkansas Valley Regional Medical Center	CO	Critical Access Hospital	$0	$6.5M
Reach Air Medical Services LLC	CO	Air Ambulance	$809.1K	$233.4K
Veronica Bartlett	CO	Family Nurse Practitioner	$148.4K	$0
Kevin Harsh	CO	Family Nurse Practitioner	$27.4K	$0

Valley-wide Health Systems, Inc — Billing Profile & Reimbursement Data

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Valley-wide 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

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$10.8M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$7.3M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$5.8M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$5.6M
Valley-wide Health Systems, Inc.	CO	Federally Qualified Health Center (FQHC)	$0	$5.2M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$4.6M
Valley-wide Health Systems, Inc.	CO	Federally Qualified Health Center (FQHC)	$0	$4.5M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$4.2M
Martin Sowards	CO	Family Medicine Physician	$105.3K	$0
Curtis Price	OR	Physical Therapist	$68.5K	$0