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.

Valley Regional Enterprises, Inc (NPI 1235178591)

Valley Regional Enterprises, Inc is a urgent care clinic/center provider located in Winchester, Virginia. This profile covers 0 Medicare and 43 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 Regional Enterprises, Inc
Address	607 E Jubal Early Dr
City	Winchester
State	VA
ZIP	22601
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	June 5, 2006

Payer Source	Total Paid
Medicaid	$8.6M
Medicare	$0

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

43 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…	44,260	$80	$3.4M
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…	40,940	$60	$2.4M
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…	11,100	$70	$799.1K
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…	4,940	$110	$523.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	15,420	$30	$508.8K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	26,010	$10	$338.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	15,380	$10	$184.6K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	5,620	$30	$151.6K
87430	The lab analyst performs an assay to evaluate the patient’s sample for antigens to Streptococcus, group A, using an immunoassay method, such as EIA.	11,030	$10	$143.4K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	1,250	$20	$28.8K

Showing 1–10 of 43

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

Valley Regional Enterprises, Inc — 13 of 25 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

43 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	98	110	1,150	$40	$331.1K
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…	45	3,520	370	$70	$280.7K
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…	59	4,010	290	$50	$199.8K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	101	210	390	$50	$106.2K
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…	384	610	150	$90	$104K
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…	32	970	100	$100	$87.1K
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…	22	1,000	100	$70	$81.1K
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,…	549	980	140	$70	$70.9K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	165	230	300	$40	$65.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	4	200	370	$30	$58.8K

Showing 1–10 of 43

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Regional Enterprises Inc	VA	Land Ambulance	$2.4M	$7.5M
Hugh Labree	VA	Family Nurse Practitioner	$50.6K	$5.4K
Jillian Wilford	WV	Family Medicine Physician	$19.3K	$29.6K
Amber Campbell	VA	Family Nurse Practitioner	$37K	$0
Natasha Waltz	VA	Family Nurse Practitioner	$34.4K	$0
Jennifer Moran	WV	Family Nurse Practitioner	$33.7K	$0
Robin Allen	WV	Physician Assistant	$23.2K	$0
Heather Neyer	VA	Family Nurse Practitioner	$22.7K	$0
Katherine Hart	WV	Family Nurse Practitioner	$22.4K	$0
Eric Mcbride	VA	Primary Care Nurse Practitioner	$10.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grafton School, Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$92M
Winchester Medical Center	VA	General Acute Care Hospital	$0	$69.9M
Grafton School Inc	VA	Psychiatric Residential Treatment Facility	$0	$33M
Shenandoah Valley Community Residences, Inc.	VA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.4M
Compassionate Home Care	VA	In Home Supportive Care Agency	$0	$14.5M
Nova Family Services, Inc.	VA	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$13.5M
Uncle Sam Transportation LLC	VA	Taxi	$0	$12M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$11.2M
Pediatrix Medical Group PC	VA	Neonatal-Perinatal Medicine Physician	$0	$10.8M
Winchester Medical Center	VA	Obstetrics & Gynecology Physician	$0	$10M

Valley Regional Enterprises, 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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