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

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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 Hospital Inc. (NPI 1306933619)

Key Findings

Field	Value
Entity Type	Organization
Organization	Valley Regional Hospital Inc.
Address	243 Elm St
City	Claremont
State	NH
ZIP	03743
Taxonomy	Critical Access Hospital
NPI Enumerated	October 6, 2006

Payer Source	Total Paid
Medicaid	$10M
Medicare	$0

VALLEY REGIONAL HOSPITAL INC. is effectively a single-payer Medicaid operator in the available claims data: there is no Medicare billing on file while total Medicaid revenue is $10M, indicating Medicaid is the primary (and only recorded) public-payer revenue source in this dataset. This concentration means analyses of payer mix, case mix, and revenue risk should focus on Medicaid trends and policy changes rather than Medicare dynamics.

Revenue concentration is high: the top 3 Medicaid codes by revenue account for 52.7% of the provider's total Medicaid revenue. Those top codes are dominated by emergency department E/M visits and CT imaging (see 99283, 74177, 99284), so a small set of services drives more than half of reported Medicaid revenue and any shifts in reimbursement or utilization for these codes would materially affect overall revenue.

The code mix indicates a service-line profile focused on emergency care and acute diagnostic imaging. Emergency department E/M codes 99283, 99284, and 99285 together represent the largest individual revenue contributions (with 99283 alone at $2.7M, 99284 at $1M, and 99285 at $808.5K), showing the hospital functions as a regional ED for Medicaid patients and relies on ED visits with low-to-moderate medical decision making as a primary revenue stream. CT imaging (74177 at $1.1M and related chest/abdomen CT codes) further signals significant onsite diagnostic capability supporting acute presentations.

Competitive standing within New Hampshire is mixed but largely typical for many codes: 99283 ranks #10 of 66 providers (86th percentile) and 99285 ranks #16 of 63 (76th percentile), indicating above-average but not dominant ED volumes for several higher-acuity E/M codes. Imaging code 74177 is mid-ranked (#23 of 47, 52th percentile) which suggests the hospital provides routine CT services but is not a leading imaging center in-state.

There are notable state-level outliers in infectious disease testing volume: 87635 (SARS–CoV–2 NAAT) ranks #4 of 56 providers (95th percentile) and 87636 (multiplex SARS–CoV–2/influenza NAAT) ranks #1 of 11 providers (100th percentile), both described as ‘‘notably above typical state volume.’’ This suggests the hospital performed an unusually high volume of COVID-related molecular testing relative to peers during the measurement period, which may reflect local testing demand or laboratory capacity.

Procedure-level volumes in ancillary services and rehab are meaningful but not dominant: physical therapy codes 97140 and 97110 each produce several hundred thousand dollars in revenue ($406.3K and $216K respectively) and rank in high percentiles among in-state peers (83rd percentile for both), indicating a substantial outpatient rehabilitation service line that complements the acute/ED focus. Likewise, routine diagnostics like CBC (85025) and CMP (80053) show typical lab throughput.

Tenure: the provider’s NPI was enumerated approximately 20 years ago (2006-10-06), evidencing long-standing presence in the market. This longevity, combined with steady Medicaid revenue and an ED-centric code mix, aligns with a community critical access hospital role serving local acute-care and diagnostic needs.

Risk and operational implications: given the absence of Medicare revenue in the file, any policy or reimbursement changes affecting Medicaid (including managed Medicaid contracting, fee-schedule adjustments, or utilization management for ED visits and CT imaging) pose outsized financial risk. Payers and analysts should monitor utilization trends for 99283, 74177, and 99284 closely, since those three codes alone drive a majority of Medicaid revenue and will be the most sensitive levers for revenue volatility.

Medicaid: Complete Services Breakdown

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

136 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	15,180	$180	$2.7M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,220	$900	$1.1M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	8,010	$130	$1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	5,390	$150	$808.5K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,830	$260	$469.2K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	5,640	$70	$406.3K
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…	5,520	$50	$259.4K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	5,840	$40	$216.1K
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…	5,020	$40	$216K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	3,000	$60	$177.1K

Showing 1–10 of 136

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Hampshire Distribution

Valley Regional Hospital Inc. — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

136 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	16	60	1,820	$150	$756.5K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	27	80	2,220	$120	$745.6K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10	70	2,540	$110	$733.8K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	23	50	1,150	$230	$480.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	20	50	1,250	$90	$224K
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…	38	420	480	$50	$223.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	22	50	2,010	$80	$209.6K
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…	23	130	1,320	$40	$184.3K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	10	60	1,020	$30	$172.2K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	11	30	2,180	$50	$160.9K

Showing 1–10 of 136

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Regional Hospital, Inc.	NH	Urgent Care Clinic/Center	$0	$875.8K
Valley Regional Hospital, Inc	NH	Family Medicine Physician	$0	$782K
Valley Regional Hospital ,inc.	NH	Emergency Medicine Physician	$0	$597.2K
Lisa Cooper	NH	Family Nurse Practitioner	$273.9K	$0
Valley Regional Hospital, Inc.	NH	Internal Medicine Physician	$0	$182.5K
Azem Dushaj	CT	Internal Medicine Physician	$121.6K	$0
Vitaliano Sicilia	NH	Internal Medicine Physician	$103.1K	$0
Jesper Brickley	VT	Family Medicine Physician	$95.8K	$0
Gregory Dadekian	NH	Internal Medicine Physician	$93K	$0
Michael Sparks	NH	Orthopaedic Surgery Physician	$83.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Developmental Services Of Sullivan County, Inc.	NH	Child Intellectual and/or Developmental Disabilities Respite Care	$0	$139.4M
Colin B Boswell Dds PC	NH	Pediatric Dentistry	$0	$5.2M
Golden Cross Ambulance Inc	NH	Ambulance	$1.2M	$3.5M
Claremont School District	NH	Local Education Agency (LEA)	$0	$3M
Daniel Peraza	NH	Dermatology Physician	$1.1M	$0
Sullivan County Oral Health Collaborative	NH	Dental Clinic/Center	$0	$892.1K
Jose E Peraza Md PLLC	NH	Dermatology Physician	$0	$870.9K
Samuel Giveen	NH	Optometrist	$120.2K	$544.2K
Tlc Family Resource Center	NH	Public Health or Welfare Agency	$0	$611.6K
Spence Dental, P.A.	NH	General Practice Dentistry	$0	$442.6K

Valley Regional Hospital 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

Related Providers

Nearby Providers

Frequently Asked Questions

References