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

Why is the Medicaid comparison limited to Colorado 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. Colorado (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-wide Health Systems, Inc (NPI 1821085994)

Field	Value
Entity Type	Organization
Organization	Valley-wide Health Systems, Inc
Address	925 2nd Ave
City	Monte Vista
State	CO
ZIP	81144
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 4, 2005

Payer Source	Total Paid
Medicaid	$7.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	15,410	$200	$3M
D0999	N/A	8,120	$350	$2.9M
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…	5,770	$190	$1.1M
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,580	$40	$92.7K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	3,120	$20	$68.7K
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,…	200	$170	$33.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	90	$260	$22K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,190	$10	$16.6K
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…	900	$20	$15.2K
D0140	Limited oral evaluation – problem focused	1,250	$10	$13.7K

Showing 1–10 of 51

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Colorado Distribution

Valley-wide Health Systems, Inc — 2 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D0999	N/A	43	150	2,140	$260	$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…	125	2,520	330	$100	$352K
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…	297	2,630	430	$90	$268.2K
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…	246	260	380	$100	$161.6K
D2392	Post 2 surface resin‑based composite	468	690	290	$130	$148K
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,…	293	690	140	$90	$118.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	212	290	160	$110	$111.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	590	720	130	$100	$110K
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…	508	630	830	$30	$102.9K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	342	410	890	$40	$101.6K

Showing 1–10 of 51

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$16.2M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$10.8M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$5.8M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$5.6M
Valley-wide Health Systems, Inc.	CO	Federally Qualified Health Center (FQHC)	$0	$5.2M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$4.6M
Valley-wide Health Systems, Inc.	CO	Federally Qualified Health Center (FQHC)	$0	$4.5M
Valley-wide Health Systems, Inc	CO	Federally Qualified Health Center (FQHC)	$0	$4.2M
Martin Sowards	CO	Family Medicine Physician	$105.3K	$0
Curtis Price	OR	Physical Therapist	$68.5K	$0

Valley-wide Health Systems, Inc — Billing Profile & Reimbursement Data

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Valley-wide 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

Frequently Asked Questions

References