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

Why is the Medicaid comparison limited to West 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. West 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.

Pleasant Valley Hospital, Inc. (NPI 1447890157)

Field	Value
Entity Type	Organization
Organization	Pleasant Valley Hospital, Inc.
Address	2520 Valley Dr
City	Point Pleasant
State	WV
ZIP	25550
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	January 10, 2020

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	37,150	$150	$5.6M
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…	10,910	$50	$545.3K
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…	6,410	$60	$397.7K
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,…	1,320	$60	$79.1K
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,…	1,760	$1	$5.3K
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…	80	$30	$2.1K
99442	N/A	130	$10	$1.5K
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.	180	$10	$900
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	200	$1	$400
99443	N/A	40	$1	$150

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. West Virginia Distribution

Pleasant Valley Hospital, Inc. — 0 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — West Virginia

Full comparison — all codes billed, vs. West Virginia median

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	52	390	4,610	$130	$2.2M
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…	288	1,270	1,240	$30	$245K
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…	88	1,030	890	$50	$221K
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…	197	340	140	$90	$97.5K
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…	378	440	110	$60	$57.2K
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,…	136	540	320	$20	$43.2K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	242	310	490	$20	$42K
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,…	28	190	190	$30	$35.9K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	131	160	220	$10	$26.9K
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.	297	330	320	$20	$24.4K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Pleasant Valley Hospital, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pleasant Valley Hospital, Inc.	WV	General Acute Care Hospital	$0	$6.6M
Point Pleasant Physician Billing Services	WV	Multi-Specialty Clinic/Center	$0	$2.2M
Pleasant Valley Hospital Inc	WV	Rural Health Clinic/Center	$0	$1M
Michael Collins	WV	Nephrology Physician	$245.3K	$0
Wesam Frandah	WV	Gastroenterology Physician	$139K	$0
Ahmed Sherif	WV	Gastroenterology Physician	$88.4K	$0
Pramod Pantangi	WV	Gastroenterology Physician	$41.3K	$0
Haitam Buaisha	IN	Gastroenterology Physician	$38.2K	$0
Tejas Joshi	WV	Hepatology Physician	$31.9K	$0
Shrikant Vaidya	WV	Urology Physician	$19.7K	$20

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hope For Tomorrow, LLC	WV	Substance Abuse Rehabilitation Facility	$0	$25.6M
New Lifeclinics Inc	WV	Addiction Medicine (Family Medicine) Physician	$0	$6.5M
Mountaineer Laboratories LLC	WV	Clinical Medical Laboratory	$13.8K	$3.7M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$3.4M
County Of Mason	WV	Land Ambulance	$369.8K	$1.9M
Mason County Action Group, Inc.	WV	Home Health Agency	$0	$2M
Mason County Emergency Ambulance Service Authority	WV	Ambulance	$0	$1.6M
Mason County Action Group Inc	WV	Home Health Agency	$0	$1.5M
David Faber	WV	Surgery Physician	$123.5K	$0
Brianna Brown	WV	Audiologist	$39.9K	$170

Pleasant Valley Hospital, Inc. — Billing Profile & Reimbursement Data

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Pleasant Valley Hospital, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References