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

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

West Valley Medical Group LLC (NPI 1871673798)

West Valley Medical Group LLC is a internal medicine physician provider located in Caldwell, Idaho. This profile covers 0 Medicare and 36 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	West Valley Medical Group LLC
Address	1906 Fairview Ave Ste 230
City	Caldwell
State	ID
ZIP	83605
Taxonomy	Internal Medicine Physician
NPI Enumerated	October 16, 2006

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	12,950	$70	$880.5K
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…	14,990	$50	$779.4K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3,220	$50	$151.2K
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…	1,240	$120	$142.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,280	$20	$41K
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…	350	$90	$30.5K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	690	$40	$26.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	270	$90	$23.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	190	$100	$19.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	450	$20	$10.2K

Showing 1–10 of 36

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

West Valley Medical Group LLC — 1 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	39	670	740	$40	$193.6K
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…	29	620	560	$60	$191.8K
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…	60	80	450	$80	$171.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	11	20	200	$90	$158.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	21	60	1,370	$50	$151.3K
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…	43	80	380	$70	$151.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	62	80	130	$80	$91.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	29	40	480	$60	$71.5K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	20	30	790	$30	$68.4K
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…	17	140	100	$90	$54.4K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
East Falls Family Medicine, LLC	ID	Family Medicine Physician	$0	$1.1M
West Valley Medical Group Specialty Services LLC	ID	Obesity Medicine (Obstetrics & Gynecology) Physician	$0	$482K
Karl Undesser	ID	Clinical Cardiac Electrophysiology Physician	$148.2K	$0
Lyndon Box	ID	Interventional Cardiology Physician	$134.5K	$0
David Hill	ID	Family Medicine Physician	$102.4K	$0
Matthew Payne	ID	Family Medicine Physician	$93K	$0
Sean Huggins	ID	Internal Medicine Physician	$82.7K	$0
Travis Moulton	ID	Family Medicine Physician	$75.8K	$0
Rebecca Swainston	ID	Family Nurse Practitioner	$58.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Alphonsus Regional Medical Center Inc	ID	Family Medicine Physician	$0	$32.6M
Saint Alphonsus Regional Medical Center Inc	ID	Rural Health Clinic/Center	$0	$9.9M
Human Supports Of Idaho	ID	General Practice Physician	$0	$9.4M
County Of Canyon Canyon Co School Dist 132	ID	Local Education Agency (LEA)	$0	$8.3M
West Valley Medical Center, Inc.	ID	General Acute Care Hospital	$0	$7.8M
Carepoint Health Emergency Medicine Idaho, PLLC	ID	Emergency Medicine Physician	$0	$4.3M
Mana Resources LLC	ID	Community/Behavioral Health Agency	$0	$3.1M
Family Eyecare Specialists PLLC	ID	Optometrist	$0	$2.9M
Hope House, Inc.	ID	Developmentally Disabled Services Day Training Agency	$0	$2.4M
Easterseals-goodwill Northern Rocky Mountain, Inc	ID	Community/Behavioral Health Agency	$0	$2M

West Valley Medical Group LLC — Billing Profile & Reimbursement Data

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West Valley Medical Group LLC — 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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