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

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

Tri Valley Care, Inc (NPI 1306081872)

Field	Value
Entity Type	Organization
Organization	Tri Valley Care, Inc
Address	4391 Sturbridge Dr
City	Harrisburg
State	PA
ZIP	17110
Taxonomy	Case Management Agency
NPI Enumerated	December 11, 2008

Payer Source	Total Paid
Medicaid	$19.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2022	Community-based wrap-around services, per diem	447,430	$30	$12.5M
W7210	N/A	99,160	$60	$5.9M
T1017	Targeted case management, each 15 minutes	13,040	$70	$873.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Pennsylvania Distribution

Tri Valley Care, Inc — 1 of 3 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Pennsylvania

Full comparison — all codes billed, vs. Pennsylvania median

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
W7210	N/A	29	70	83,330	$80	$10M
H2022	Community-based wrap-around services, per diem	1	10	223,850	$30	$6.4M
T1017	Targeted case management, each 15 minutes	132	210	18,200	$100	$2.9M

Nearby Providers

Other providers in the same ZIP code as Tri Valley Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Youth Advocate Programs, Inc.	PA	Community/Behavioral Health Agency	$0	$101M
Keystone Service Systems, Inc.	PA	Intellectual & Developmental Disabilities Psychologist	$0	$85.6M
Pediatric Services Of America, LLC	PA	Home Health Agency	$0	$31.5M
Maxim Healthcare Services Inc	PA	Home Health Agency	$0	$20.9M
Center For Behavioral Health Ha, LLC	PA	Methadone Clinic	$169.3K	$14.3M
Global Healthcare Group, LLC	PA	Home Health Agency	$0	$11.9M
Adrian Harewood	PA	General Practice Physician	$967.8K	$3.3K
Capital Surgery And Laser Center, LLC	PA	Ambulatory Surgical Clinic/Center	$785.8K	$0
Elena Farrell	PA	Ophthalmology Physician	$277.2K	$0
Maciej Charczuk	PA	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$44.8K	$226.3K

Tri Valley Care, Inc — Billing Profile & Reimbursement Data

Sign up for Tri Valley Care, Inc — Billing Profile & Reimbursement Data policy alerts

Tri Valley Care, Inc — Billing Profile & Reimbursement Data

Sign up for Tri Valley Care, Inc — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References