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

Why is the Medicaid comparison limited to Massachusetts 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. Massachusetts (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 Medical Group, P.C. (NPI 1912924705)

Valley Medical Group, P.C. is a family medicine physician provider located in Greenfield, Massachusetts. This profile covers 0 Medicare and 113 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	Valley Medical Group, P.C.
Address	329 Conway St
City	Greenfield
State	MA
ZIP	01301
Taxonomy	Family Medicine Physician
NPI Enumerated	July 16, 2006

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

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

113 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…	112,920	$50	$5.5M
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…	59,480	$40	$2.4M
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	3,980	$80	$314.4K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	6,150	$30	$190.5K
92340	Code 92340 describes the fitting of eyeglasses, except for aphakia (absence of the crystalline lens as after cataract surgery); monofocal	3,540	$30	$99.1K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	2,490	$40	$97.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	5,460	$20	$87.4K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	1,380	$60	$75.8K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	6,810	$10	$74.9K
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…	1,520	$50	$71.2K

Showing 1–10 of 113

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Massachusetts Distribution

Valley Medical Group, P.C. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Massachusetts

Full comparison — all codes billed, vs. Massachusetts median

113 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	82	130	1,830	$60	$974.3K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	359	410	140	$110	$742.2K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	118	120	530	$450	$681.5K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	89	370	500	$40	$605.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	284	1,620	580	$80	$599.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	625	1,020	460	$100	$293.7K
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,…	86	950	90	$100	$212.9K
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…	25	5,040	200	$70	$209.5K
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…	88	670	120	$100	$169.2K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	136	160	570	$10	$167.2K

Showing 1–10 of 113

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Medical Group, P.C.	MA	Ambulatory Surgical Clinic/Center	$280.8K	$10K
Michael Reeves	MA	Family Medicine Physician	$235K	$1.9K
Marguerite Gump	MA	Family Medicine Physician	$214.3K	$3.2K
Niloufar Shoushtari	MA	Internal Medicine Physician	$217.2K	$0
Kharmen Lopez Del Castillo	MA	Family Medicine Physician	$196.2K	$0
Robert Vigderman	MA	Internal Medicine Physician	$193.6K	$0
Valley Medical Group, P.C.	MA	Clinical Medical Laboratory	$80.2K	$109.1K
Steven Esrick	MA	Family Medicine Physician	$186.9K	$1.1K
Jennifer Depiero	MA	Family Medicine Physician	$169.9K	$880
Paul Carlan	MA	Internal Medicine Physician	$161.8K	$3.9K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clinical & Support Options, Inc	MA	Community/Behavioral Health Agency	$0	$147.7M
Baystate Franklin Medical Center	MA	General Acute Care Hospital	$0	$29.1M
Lifepath, Inc.	MA	Adult Care Home Facility	$0	$19.7M
Lifepath, Inc.	MA	Case Management Agency	$0	$18.7M
Community Health Center Of Franklin County Incorporated	MA	Federally Qualified Health Center (FQHC)	$0	$9.4M
Lifepath, Inc.	MA	Personal Care Attendant	$0	$8.7M
Servicenet Inc	MA	Addiction (Substance Use Disorder) Counselor	$0	$8M
Franklin Mri Center LLC	MA	Magnetic Resonance Imaging (MRI) Clinic/Center	$285.4K	$849.2K
Suzanne Smith	MA	Addiction Medicine (Internal Medicine) Physician	$78.7K	$587.5K
James Arcoleo	MA	Cardiovascular Disease Physician	$617.8K	$44K

Valley Medical Group, P.C. — Billing Profile & Reimbursement Data

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Valley Medical Group, P.C. — 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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