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

Why is the Medicaid comparison limited to Georgia 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. Georgia (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 Healthcare System Inc (NPI 1609814219)

Field	Value
Entity Type	Organization
Organization	Valley Healthcare System Inc
Address	1600 Fort Benning Road
City	Columbus
State	GA
ZIP	31903
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	June 4, 2006

Payer Source	Total Paid
Medicaid	$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.

60 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	9,290	$60	$575.8K
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…	4,960	$20	$84.3K
D1120	Prophylaxis–child	1,800	$30	$57.7K
D0999	N/A	360	$130	$45.8K
D1351	Sealant - per tooth	590	$70	$39.3K
D0140	Limited oral evaluation – problem focused	370	$80	$28.9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	1,770	$20	$26.5K
D0120	Periodic oral evaluation - established patient	1,240	$20	$26.1K
D0272	N/A	1,190	$20	$23.7K
D0150	Comprehensive oral evaluation – new or established patient	710	$30	$22.6K

Showing 1–10 of 60

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Valley Healthcare System Inc — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

60 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	7	10	2,280	$80	$470.3K
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…	167	920	370	$60	$360.6K
T1015	Clinic visit/encounter, all-inclusive	3	50	100	$100	$293.2K
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…	261	820	390	$70	$245K
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…	130	180	680	$90	$226.7K
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…	147	180	720	$90	$204.2K
D1351	Sealant - per tooth	35	70	580	$30	$176.7K
D1120	Prophylaxis–child	38	140	620	$30	$173.7K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	124	250	660	$40	$172.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	146	170	500	$100	$170.6K

Showing 1–10 of 60

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Comprehensive Community Mental Health Center, Inc.	WV	Mental Health Counselor	$0	$16.7M

Valley Healthcare System Inc — Billing Profile & Reimbursement Data

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Valley Healthcare System 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

Frequently Asked Questions

References