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 Center, Inc. (NPI 1891732905)

Key Findings

Field	Value
Entity Type	Organization
Organization	West Valley Medical Center, Inc.
Address	1717 Arlington Ave
City	Caldwell
State	ID
ZIP	83605
Taxonomy	General Acute Care Hospital
NPI Enumerated	May 31, 2006

Payer Source	Total Paid
Medicaid	$7.8M
Medicare	$0

WEST VALLEY MEDICAL CENTER is effectively a Medicaid-focused billing entity: Medicare revenue is listed as none (no Medicare billing on file) while total Medicaid revenue is $7.8M, indicating the provider’s public reimbursement activity reported here is concentrated in Medicaid rather than Medicare. This payer mix suggests the facility’s financial footprint in these datasets is primarily driven by state Medicaid activity rather than federal Medicare claims.

Revenue is highly concentrated in three codes: 99283 ($1.9M, 27.6%), 99284 ($1.7M, 23.4%), and 92507 ($564.7K, 8.0%), which together account for 59.0% of the provider’s total Medicaid revenue. That concentration implies that a majority of Medicaid dollars flow through a small set of evaluation-and-management and specialty assessment services rather than a broad, evenly distributed case mix.

The top codes point to an emergency-department–centric operating profile: 99283 and 99284 are the two largest Medicaid revenue drivers and both describe ED E/M visits at low-to-moderate medical decision-making levels. Additional ED codes on the list (99285, 99282, 99281) further support that emergency care is a primary service line, consistent with the provider’s taxonomy as a General Acute Care Hospital.

Competitive standing within Idaho is mixed but leans toward above-average ED volume: 99283 ranks #6 of 83 providers (94th percentile) and 99284 ranks #11 of 75 providers (86th percentile), indicating elevated state-level ED activity for those specific services. At the same time, many other high-volume codes are described as "typical, unremarkable volume," so the hospital appears regionally competitive primarily on core ED throughput rather than across every ancillary service.

Several ancillary services show high relative volume or notable state outlier status: 87502 (influenza multiplex testing) is ranked #2 of 48 providers and described as "notably above typical state volume," 96372 (therapeutic/prophylactic injection) is described as "notably above typical state volume," and 85027 (CBC) is ranked #2 of 33 and also labeled "notably above typical state volume." These flags suggest the hospital runs higher-than-typical throughput for selected lab and injection services compared with in-state peers.

The itemized code mix (labs such as 87502, 80053, 85027; imaging such as 74177 and 70450; cardiac imaging 93306; IV/infusion administration codes 96374/96375; and therapy codes like 97110 and 97530) is consistent with a full-service acute-care hospital that supports emergency stabilization, diagnostic imaging, laboratory diagnostics, and basic rehabilitative services. This breadth underscores that Medicaid revenue is tied not just to ED visits but to downstream diagnostics and treatment provided on site.

The provider has a long tenure in the NPI registry, enumerated on 2006-05-31 (~20 years ago), which indicates sustained operation over multiple market cycles; combined with the Medicaid revenue concentration and ED focus, this suggests an established local hospital that primarily serves Medicaid populations.

Because the dataset shows no Medicare billing on file, payers and analysts should treat this profile as effectively single-payer (Medicaid) for the purposes of evaluating historical claims activity; absence of Medicare data means conclusions about Medicare-facing competitiveness or service mix cannot be drawn from this record alone.

Medicaid: Complete Services Breakdown

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

175 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.	13,700	$140	$1.9M
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.	8,930	$190	$1.7M
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	9,740	$60	$564.7K
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.	2,020	$250	$510K
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.	4,080	$90	$350.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	4,750	$50	$242.3K
87502	The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…	2,770	$80	$232.5K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	2,940	$70	$196.8K
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.	1,510	$120	$178.5K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6,160	$30	$172.4K

Showing 1–10 of 175

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 Center, Inc. — 3 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

175 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	17	20	500	$820	$662.5K
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.	22	60	1,080	$110	$595.5K
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.	11	80	1,020	$90	$502.7K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	76	280	1,480	$70	$389.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	50	210	3,020	$50	$389K
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.	6	80	880	$70	$265.5K
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.	17	40	530	$70	$237.8K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	21	20	4,340	$10	$236.8K
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…	506	620	560	$60	$191.8K
66984	The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to…	10	20	150	$360	$178.3K

Showing 1–10 of 175

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
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
West Valley Medical Group LLC	ID	Internal Medicine Physician	$0	$2.1M
Easterseals-goodwill Northern Rocky Mountain, Inc	ID	Community/Behavioral Health Agency	$0	$2M

West Valley Medical Center, Inc. — Billing Profile & Reimbursement Data

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West Valley Medical Center, 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

Nearby Providers

Frequently Asked Questions

References