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

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

Northern Valley Indian Health Inc (NPI 1295752384)

Field	Value
Entity Type	Organization
Organization	Northern Valley Indian Health Inc
Address	207 N Butte St
City	Willows
State	CA
ZIP	95988
Taxonomy	Clinic/Center
NPI Enumerated	July 16, 2006

Payer Source	Total Paid
Medicaid	$217.1M
Medicare	$0

Key Findings

This entity is effectively a single-payer Medicaid provider: there is no Medicare billing on file and lifetime Medicaid revenue is $217.1M. The provider’s NPI was enumerated 2006-07-16 (~20 years ago), indicating long tenure in the market and an established operational footprint in Willows, CA as a Clinic/Center.

Revenue is highly concentrated in a very small set of Medicaid codes: the precomputed top 3 codes account for 96.1% of Medicaid revenue. Those top codes are 00003 (219.7K claims, $528 avg paid/claim, $116M revenue; 53.5%), T1015 (162.9K claims, $543 avg paid/claim, $88.5M revenue; 40.8%), and G0467 (15.2K claims, $253 avg paid/claim, $3.8M revenue; 1.8%).

The code mix points to an FQHC/clinic-style operating model focused on bundled clinic encounters and high-volume outpatient visits: T1015 (clinic visit/encounter, all-inclusive) and G0467 (FQHC established visit) together form the bulk of reimbursed services and align with the provider’s Clinic/Center taxonomy. Supplemental codes in the file—including high-volume E/M codes (99213: 58.1K claims, $44 avg, $2.6M; 99214: 32.8K claims, $34 avg, $1.1M) and preventive/pediatric codes (99391/99392/99393)—support a primary care, preventive, and pediatrics service mix delivered at scale.

Competitive standing is uneven across codes: 00003 ranks #5 of 688 providers in-state (99th percentile; notably above typical state volume), signaling that this provider is a dominant state-level performer for that single revenue-driving code. By contrast, T1015 ranks #193 of 1550 (88th percentile; typical, unremarkable volume), indicating solid but not exceptional statewide position on that broadly used clinic-encounter code.

Several codes indicate program-specific strengths beyond pure visit volume. G0467 ranks #42 of 1029 providers in-state (96th percentile; notably above typical state volume), reinforcing strong FQHC-style established patient activity, while G2025 (telehealth for RHC/FQHC) shows 13K claims, $9 avg paid/claim, $116.8K revenue and ranks #3 of 575 (100th percentile; extreme outlier), highlighting an outsized telehealth or distant-site billing footprint relative to peers despite its smaller revenue share.

Behavioral health and developmental services appear as meaningful components of the care mix: psychotherapy and psychiatric codes (90837: 7.1K claims, $65 avg, $461.6K; 90834: 8.3K claims, $46 avg, $383.2K; 90832: 5.3K claims, $32 avg, $168.2K) and developmental screening (96110: 9K claims, $49 avg, $441.8K) all rank high in-state (mostly 93rd–97th percentiles). This pattern suggests integrated mental health and developmental screening capacity embedded in primary care operations.

The provider’s revenue concentration—96.1% from the top three codes—creates a dependency on a narrow set of clinic/FQHC encounter payments and a single large, unlabeled code 00003 that drives more than half the Medicaid revenue. That concentration could represent stable, program-driven funding for core clinic services but also signals limited diversification of Medicaid revenue streams.

Operationally, the dataset shows high throughput at Medicaid reimbursement levels: large claim volumes for lower per-claim E/M payments (e.g., 99213: 58.1K claims at $44 avg; 99214: 32.8K claims at $34 avg) indicate reliance on visit volume and bundled clinic payments to generate overall revenue, consistent with a high-volume community clinic or FQHC delivery model.

Medicaid: Complete Services Breakdown

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

148 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
00003	N/A	219,680	$530	$116M
T1015	Clinic visit/encounter, all-inclusive	162,920	$540	$88.5M
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…	15,190	$250	$3.8M
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…	58,130	$40	$2.6M
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…	32,770	$30	$1.1M
0561	N/A	4,860	$120	$578.6K
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…	11,110	$40	$477.6K
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…	11,640	$40	$477K
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…	7,100	$70	$461.6K
59425	This service is considered a mini global code for the provider who provides only four to six of the patient’s antepartum visits. This can happen when the patient transfers out of the practice prior…	2,250	$200	$445.7K

Showing 1–10 of 148

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. California Distribution

Northern Valley Indian Health Inc — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — California

Full comparison — all codes billed, vs. California median

148 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	193	1,550	38,050	$190	$14.1M
00003	N/A	5	690	14,940	$260	$7.7M
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	73	250	800	$110	$625.7K
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…	307	4,290	780	$140	$400.1K
0561	N/A	2	20	380	$170	$245.6K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	331	390	250	$200	$220.4K
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…	42	1,030	1,050	$70	$219.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	1,121	2,110	1,330	$30	$200.7K
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…	113	1,950	500	$80	$179K
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…	381	13,300	640	$40	$169.6K

Showing 1–10 of 148

Northern Valley Indian Health Inc — Billing Profile & Reimbursement Data

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Northern Valley Indian Health Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Frequently Asked Questions

References