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.

Valley Health Systems, Inc (NPI 1528038577)

Field	Value
Entity Type	Organization
Organization	Valley Health Systems, Inc
Address	42 Mcginnis Dr
City	Wayne
State	WV
ZIP	25570
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 24, 2006

Payer Source	Total Paid
Medicaid	$14.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

63 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	76,230	$180	$13.5M
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…	35,810	$10	$214.8K
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	2,910	$40	$107.6K
D9999	N/A	420	$230	$96K
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…	18,610	$1	$55.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,940	$10	$31.5K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,630	$10	$22.9K
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,…	4,040	$10	$20.2K
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…	960	$10	$6.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	1,470	$1	$5.9K

Showing 1–10 of 63

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

Valley Health Systems, Inc — 3 of 25 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

63 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	14	390	4,610	$130	$2.2M
S0281	Medical home program, comprehensive care coordination and planning, maintenance of plan	10	30	1,020	$50	$438.2K
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…	62	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…	43	1,030	890	$50	$221K
D2392	Post 2 surface resin‑based composite	119	130	170	$100	$93.1K
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…	66	150	520	$50	$76.2K
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…	47	100	120	$100	$69.6K
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…	65	140	550	$50	$67.2K
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…	135	210	280	$40	$59.2K
90832	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…	33	200	490	$30	$57.7K

Showing 1–10 of 63

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$17.2M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.4M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$13.2M
Valley Health Systems, Inc.	WV	Federally Qualified Health Center (FQHC)	$0	$11M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.2M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$10.1M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$8.8M
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$8.6M
Valley Health Systems Inc	WV	Clinical Medical Laboratory	$299.4K	$7M
Valley Health Systems, Inc	WV	Federally Qualified Health Center (FQHC)	$0	$7.1M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wayne Volunteer Fire Department	WV	Land Ambulance	$55.9K	$939.9K
Valley Health Systems Inc	WV	Federally Qualified Health Center (FQHC)	$0	$812.9K

Valley Health Systems, Inc — Billing Profile & Reimbursement Data

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Valley Health Systems, 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