Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers

VALLEY PHYSICIAN ENTERPRISE INC

NPI: 1922543677 · WINCHESTER, VA 22601 · Clinical Social Worker · NPI assigned 01/04/2017

Billing Flags · Automated signals — not evidence of fraud
Entity Proliferation

Authorized official JOHNSON, RENEE controls 20+ related entities in our dataset. Read more

$1.58M
Total Medicaid Paid
42,849
Total Claims
38,842
Beneficiaries
26
Codes Billed
2018-01
First Month
2024-12
Last Month

Provider Details

Authorized OfficialJOHNSON, RENEE (CREDENTIALING COORDINATOR)
Parent OrganizationVALLEY HEALTH SYSTEM
NPI Enumeration Date01/04/2017

Related Entities

Other providers sharing the same authorized official: JOHNSON, RENEE

ProviderCityStateTotal Paid
PAGE MEMORIAL HOSPITAL, INC. LURAY VA $14.04M
EAST MOUNTAIN HEALTH PHYSICIANS, INC. RANSON WV $5.15M
WAR MEMORIAL HOSPITAL, INC. BERKELEY SPRINGS WV $4.55M
SHENANDOAH MEMORIAL HOSPITAL, INC. WOODSTOCK VA $1.98M
VALLEY PHYSICIAN ENTERPRISE, INC WINCHESTER VA $1.80M
PAGE MEMORIAL HOSPITAL INC. LURAY VA $1.33M
WAR MEMORIAL HOSPITAL, INC. BERKELEY SPRINGS WV $748K
VALLEY PHYSICIAN ENTERPRISE, INC. WINCHESTER VA $710K
VALLEY PHYSICIAN ENTERPRISE, INC. WINCHESTER VA $673K
SHENANDOAH MEMORIAL HOSPITAL, INC. STRASBURG VA $657K
PAGE MEMORIAL HOSPITAL INC. STANLEY VA $597K
VALLEY PHYSICIAN ENTERPRISE, INC. WINCHESTER VA $590K
EAST MOUNTAIN HEALTH PHYSICIANS, INC. INWOOD WV $584K
VALLEY PHYSICIAN ENTERPRISE, INC. WINCHESTER VA $479K
PAGE MEMORIAL HOSPITAL INC. LURAY VA $446K
EAST MOUNTAIN HEALTH PHYSICIANS, INC. MARTINSBURG WV $361K
PAGE MEMORIAL HOSPITAL INC. LURAY VA $338K
EAST MOUNTAIN HEALTH PHYSICIANS, INC. MARTINSBURG WV $328K
EAST MOUNTAIN HEALTH PHYSICIANS, INC. HEDGESVILLE WV $275K
VALLEY PHYSICIAN ENTERPRISE, INC. WINCHESTER VA $274K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 1,444 $50K
2019 5,205 $256K
2020 4,997 $300K
2021 7,764 $222K
2022 9,738 $283K
2023 8,933 $266K
2024 4,768 $206K

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
99214 Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity 15,388 13,745 $1.07M
99213 Office or other outpatient visit for the evaluation and management of an established patient, low complexity 5,666 4,955 $260K
99204 Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity 1,024 950 $102K
99215 Prolong outpt/office vis 474 445 $49K
99203 Office or other outpatient visit for the evaluation and management of a new patient, low complexity 475 425 $30K
3074F 5,405 4,981 $13K
90686 832 738 $12K
3078F 5,238 4,829 $12K
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine 1,357 1,229 $8K
3079F 2,712 2,552 $7K
99490 Ccm add 20min 382 348 $5K
3075F 1,734 1,633 $5K
90715 83 82 $3K
3077F 1,110 1,028 $2K
87428 60 59 $2K
90834 Psychotherapy, 45 minutes with patient 35 13 $2K
3080F 456 429 $850.00
90656 34 34 $699.23
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward 13 12 $624.86
99406 85 83 $515.52
87426 Infectious agent antigen detection, SARS-CoV-2 (COVID-19) 13 13 $409.44
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 13 12 $363.40
G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source 17 15 $307.11
90472 Immunization administration, each additional vaccine (list separately) 73 66 $235.59
81002 12 12 $24.55
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity 158 154 $16.01