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

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

Midvalley Healthcare PLLC (NPI 1346573532)

Midvalley Healthcare PLLC is a mental health clinic/center (including community mental health center) provider located in Meridian, Idaho. This profile covers 0 Medicare and 11 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	Midvalley Healthcare PLLC
Address	2321 E Gala St Ste 3
City	Meridian
State	ID
ZIP	83642
Taxonomy	Mental Health Clinic/Center (Including Community Mental Health Center)
NPI Enumerated	September 7, 2009

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8,640	$90	$760.3K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	26,030	$30	$676.7K
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…	4,430	$50	$212.6K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	2,050	$60	$129.2K
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…	2,150	$40	$92.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	620	$120	$72.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	1,030	$50	$52.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	630	$70	$45K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	110	$80	$8.5K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	20	$110	$2.5K

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Midvalley Healthcare PLLC — 2 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	209	670	740	$40	$193.6K
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…	561	620	560	$60	$191.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2	20	200	$90	$158.3K
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…	16	60	1,370	$50	$151.3K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	1	30	1,070	$30	$73.5K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	33	40	480	$60	$71.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	13	40	300	$120	$66.3K
99221	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	1	10	30	$60	$31K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	6	30	180	$70	$25.2K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	32	40	120	$80	$21.4K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Duke Nyarecha	ID	Psychiatric/Mental Health Nurse Practitioner	$38.5K	$0
Gretchen Gayle	ID	Psychiatric/Mental Health Nurse Practitioner	$31.3K	$0
Jeremy Hurst	ID	Psychiatric/Mental Health Nurse Practitioner	$29.1K	$0
Shelley Wray	ID	Psychiatric/Mental Health Nurse Practitioner	$16.7K	$0
Megan Conover	ID	Physician Assistant	$12K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Norco, Inc.	ID	Durable Medical Equipment & Medical Supplies	$0	$41M
Joint School District No. 2	ID	Local Education Agency (LEA)	$0	$34.2M
Chatterbox Speech & Language Center	ID	Speech-Language Pathologist	$0	$10.6M
St. Fillan's, LLC	ID	In Home Supportive Care Agency	$0	$10.5M
Southern Idaho Health Partners LLC	ID	General Practice Physician	$0	$9.2M
Gem State Developmental Center LLC	ID	Developmentally Disabled Services Day Training Agency	$0	$9.1M
Addus Healthcare, Inc.	ID	In Home Supportive Care Agency	$0	$6.1M
Northwest Neurobehavioral Health, LLC	ID	Clinical Social Worker	$0	$5.2M
Idaho Pediatric Therapy Clinic PLLC	ID	Physical Therapist	$0	$3.1M
Cpapnow Inc	ID	Durable Medical Equipment & Medical Supplies	$0	$3.1M

Midvalley Healthcare PLLC — Billing Profile & Reimbursement Data

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Midvalley Healthcare PLLC — 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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