Physician
Valley Physician Enterprise, INC.
Valley Physician Enterprise, INC. was paid $171K by Medicaid between Jan 2018 and Sep 2018, across 24 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 64% of everything it billed.
33Billing provider infoVALLEY PHYSICIAN ENTERPRISE, INC.
FRONT ROYAL, VA 22630
FRONT ROYAL, VA 22630
33aNPI1447799416assigned 02/23/2017
33bProvider typePediatrics Physician
28Total paid$171K
24GClaims5,942
24DCodes billed24
24AFirst – last monthJan 2018 – Sep 2018
Compared with peers
Next to other Pediatrics Physician providers in Virginia
Rank by total paid#195 of 817
Median peer was paid$29K
This provider vs. median5.8×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 5,942 | $171K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 64% | 2,124 | 1,835 | $109K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 11% | 249 | 248 | $18K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.6% | 121 | 120 | $9K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 5.5% | 124 | 121 | $9K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 4.2% | 95 | 87 | $7K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.1% | 42 | 42 | $4K |
| 90670 | 1.9% | 159 | 157 | $3K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 1.8% | 232 | 227 | $3K |
| 90698 | <1% | 59 | 58 | $1K | |
| 99000 | <1% | 269 | 254 | $893.12 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 112 | 101 | $842.43 |
| 90651 | <1% | 28 | 28 | $820.07 |
12 more codes
| 90707 | <1% | 44 | $661.59 | |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | <1% | 1,292 | $532.57 |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 35 | $471.20 |
| 90461 | <1% | 717 | $317.25 | |
| 90648 | <1% | 29 | $316.71 | |
| 90633 | <1% | 28 | $311.96 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 111 | $300.09 |
| 90716 | <1% | 13 | $258.34 | |
| 90686 | <1% | 20 | $211.97 | |
| 90723 | <1% | 14 | $155.98 | |
| 90680 | <1% | 12 | $132.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 13 | $3.40 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialBAKER, RENEE (MANAGER, INSURANCE CREDENITALING)
| Provider | Location | Paid |
|---|---|---|
| Hampshire Memorial Hospital, INC. | Romney, WV | $4.22M |
| Shenandoah Memorial Hospital INC. | Woodstock, VA | $2.49M |
| War Memorial Hospital, INC. | Berkeley Springs, WV | $1.06M |
| Shenandoah Memorial Hospital INC. | New Market, VA | $936K |
| Shenandoah Memorial Hospital INC. | Woodstock, VA | $384K |
| Shenandoah Memorial Hospital INC. | Mount Jackson, VA | $373K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.