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

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

Mid-valley Healthcare Inc (NPI 1689625980)

Key Findings

Field	Value
Entity Type	Organization
Organization	Mid-valley Healthcare Inc
Address	525 N Santiam Highway
City	Lebanon
State	OR
ZIP	97355
Taxonomy	Critical Access Hospital
NPI Enumerated	May 12, 2006

Payer Source	Total Paid
Medicaid	$34.5M
Medicare	$0

MID-VALLEY HEALTHCARE INC shows an effectively single-payer footprint: there is no Medicare billing on file and the provider reports $34.5M in lifetime Medicaid revenue, indicating Medicaid is the dominant (and only reported) source of federal program revenue for this entity. The provider's taxonomy as a Critical Access Hospital is consistent with a rural, Medicaid-focused safety-net role and helps explain the lack of Medicare billing in the file.

Revenue is highly concentrated in emergency-department evaluation-and-management codes: 99284 ($10.3M, 31.0%), 99283 ($7.3M, 22.1%) and 99285 ($4.8M, 14.5%) together account for 67.6% of this provider's total Medicaid revenue. This concentration signals that ED visits are the primary revenue driver and that changes in ED utilization or Medicaid reimbursement for these codes would materially affect the provider's top-line.

The code mix and dollar distribution indicate an ED-centric operating model with on-site imaging and lab capacity: high-revenue ED codes (99284/99283/99285) are complemented by 74177 CT abdomen/pelvis ($1.9M), 70450 CT head ($219.8K) and lab panels such as 80053 CMP ($1.1M) and 85025 CBC ($710.1K). Taken together, these codes suggest continuous emergency throughput supported by diagnostic imaging and laboratory services rather than a narrow outpatient-only clinic footprint.

Competitive standing within the state is modest-to-strong but not dominant for the ED portfolio: 99283 ranks #12 of 137 in-state (92th percentile; typical, unremarkable volume), 99284 ranks #17 of 145 (89th percentile; typical, unremarkable volume), and 99285 ranks #27 of 129 (80th percentile; typical, unremarkable volume). In plain terms, MID-VALLEY is a solid regional ED participant with above-average volume for several ED codes but does not consistently sit at the very top of statewide volume for its highest-revenue services.

There are specific codes where MID-VALLEY is an above-typical statewide performer: 99282 ranks #3 of 84 providers (98th percentile; notably above typical state volume for this code), Q9967 ranks in the 91th percentile (notably above typical state volume), and J7120 ranks in the 95th percentile (notably above typical state volume). These outlier positions point to pockets of specialty utilization—higher-than-typical lower-complexity ED visits and above-typical use of certain contrast and fluid infusion supplies—that may reflect local practice patterns or supply protocols.

Payment-per-claim patterns reinforce an acuity-weighted ED revenue mix: average paid per claim is $271 for 99285 (high-complexity ED), $246 for 99284 (moderate complexity), and $166 for 99283 (lower-moderate complexity). The higher average for 99285 indicates a meaningful contribution to revenue from higher-acuity cases even though 99285 is smaller by claim volume than 99283/99284.

High claim volumes across basic diagnostic and specimen services underscore operational throughput: 80053 has 45.2K claims, 85025 has 37.4K claims and 36415 has 39.2K claims, together supporting the ED-focused picture with substantial point-of-care lab and phlebotomy activity. These high-frequency, lower-dollar services are consistent with a facility that handles many acute visits and invests in routine diagnostics to support those encounters.

MID-VALLEY has long tenure in the NPI registry (NPI enumerated: 2006-05-12 (~20 years ago)), which suggests an established presence in its market. That longevity, combined with the Critical Access Hospital taxonomy and the Medicaid-heavy revenue profile, points to a stable, rural acute-care provider whose financial performance will be sensitive to Medicaid policy and regional ED demand.

Medicaid: Complete Services Breakdown

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

101 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	41,800	$250	$10.3M
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.	44,030	$170	$7.3M
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.	17,770	$270	$4.8M
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.	2,310	$810	$1.9M
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.	18,910	$90	$1.7M
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.	45,240	$20	$1.1M
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…	37,370	$20	$710.1K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	12,280	$50	$663.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	9,190	$70	$661.8K
G0330	Facility services for dental rehabilitation procedure(s) performed on a patient who requires monitored anesthesia (e.g., general, intravenous sedation (monitored anesthesia care) and use of an…	110	$4,640	$491.6K

Showing 1–10 of 101

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Oregon Distribution

Mid-valley Healthcare Inc — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. Oregon median

101 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	17	150	7,400	$170	$2.8M
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.	27	130	2,610	$200	$2.3M
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	140	10,160	$130	$2.3M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	22	40	3,200	$60	$1.5M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	20	60	3,620	$90	$623.7K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	15	20	190	$1,070	$556K
G0480	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…	18	60	420	$60	$405.1K
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.	3	80	1,130	$90	$327.2K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	35	40	310	$420	$325.7K
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…	978	1,500	650	$70	$312.4K

Showing 1–10 of 101

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Albany General Hospital	OR	General Acute Care Hospital	$0	$25.5M
Samaritan Pacific Health Services, Inc	OR	Critical Access Hospital	$0	$20.6M
Good Samaritan Hospital Corvallis	OR	General Acute Care Hospital	$0	$14.6M
Samaritan North Lincoln Hospital	OR	Critical Access Hospital	$0	$12.3M
Samaritan Pacific Health Services, Inc.	OR	Oxygen Equipment & Supplies (DME)	$0	$7.2M
Albany General Hospital	OR	Pediatrics Physician	$0	$4.9M
Albany General Hospital	OR	Family Medicine Physician	$0	$4.5M
Samaritan Endoscopy LLC	OR	Ambulatory Surgical Clinic/Center	$474.4K	$3.8M
Mid-valley Healthcare, Inc.	OR	Rural Health Clinic/Center	$0	$4.2M
Mid-valley Healthcare, Inc.	OR	Rural Health Clinic/Center	$0	$3M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwest Premier LLC	OR	Mental Illness Community Based Residential Treatment Facility	$0	$6.6M
Samaritan Pacific Health Services, Inc.	OR	Oxygen Equipment & Supplies (DME)	$0	$3.3M
Lebanon Fire District	OR	Land Ambulance	$413.3K	$2.7M
Breaking Free, LLC	OR	Community/Behavioral Health Agency	$0	$3M
Mid-valley Healthcare, Inc.	OR	Substance Abuse Rehabilitation Facility	$0	$2.8M
Mid-valley Healthcare, Inc.	OR	Rural Health Clinic/Center	$0	$2.5M
Mid-valley Healthcare, Inc.	OR	Rural Health Clinic/Center	$0	$2.2M
Fresenius Medical Care Dialysis Services - Oregon, LLC	OR	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Mid-valley Healthcare, Inc.	OR	Rural Health Clinic/Center	$0	$1.1M
Kyle Horner	OR	Dermatology Physician	$172K	$0

Mid-valley Healthcare Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References