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 1598975120)

Pleasant Valley Hospital, Inc. is a general acute care hospital provider located in Pt Pleasant, West Virginia. This profile covers 0 Medicare and 215 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	Pleasant Valley Hospital, Inc.
Address	2520 Valley Dr
City	Pt Pleasant
State	WV
ZIP	25550
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 23, 2007

Payer Source	Total Paid
Medicaid	$6.6M
Medicare	$0

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

215 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.	12,440	$80	$945.7K
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.	3,080	$210	$639.6K
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.	3,040	$90	$279.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	28,460	$10	$256.1K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	18,170	$10	$236.2K
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.	4,990	$50	$224.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	34,280	$10	$205.7K
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…	7,030	$30	$189.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	8,420	$10	$109.4K
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,…	4,000	$30	$107.9K

Showing 1–10 of 215

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 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

215 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.	59	130	2,090	$210	$1.5M
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	12	20	1,050	$80	$1.3M
87491	The lab analyst performs a test for Chlamydia trachomatis using amplified nucleic acid probe technique.	24	40	820	$30	$1.2M
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	24	40	820	$30	$1.2M
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.	86	170	3,350	$120	$1.1M
88175	The lab analyst performs the technical lab test to analyze a cervical or vaginal cytopathology specimen that a clinician collected in preservative fluid. The test uses automated thin layer…	14	20	70	$20	$832.7K
87798	The lab analyst performs a test for an infectious agent not specified in another code using an amplified nucleic acid probe technique. Use this code if you know the laboratory technique is amplified…	16	30	180	$40	$773.3K
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.	36	160	3,690	$80	$714.8K
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.	45	80	950	$140	$559.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	43	110	2,080	$50	$537.1K

Showing 1–10 of 215

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pleasant Valley Hospital, Inc.	WV	Rural Health Clinic/Center	$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

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

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