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SHENANDOAH VALLEY MEDICAL SYSTEM, INC.

Clinic/Center, Federally Qualified Health Center (FQHC)·MARTINSBURG, WV·NPI: 1083617823Share

Compared to Clinic/Center, Federally Qualified Health Center (FQHC) Peers

Total spending distribution among 16 providers in this specialty

P25MedianP75P90

This provider's total spending of $61.2M is at the below 25th percentile among 16 Clinic/Center, Federally Qualified Health Center (FQHC) providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$61.2M

$61,177,730

Total Claims

952K

Beneficiaries

593K

1.6 claims/patient

Avg Cost/Claim

$64

Monthly Spending Trend

Yearly Spending

2018
$7.7M
-58%
2019
$3.2M
+86%
2020
$6.0M
+40%
2021
$8.4M
+77%
2022
$14.8M
-15%
2023
$12.5M
-31%
2024
$8.6M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 50 distinct procedure codes. The top code (T1015 (Clinic visit/encounter, all-inclusive)) accounts for 90% of total spending.

T1015Normal range

Clinic visit/encounter, all-inclusive

$55.2M

380K claims · 90.2%

Your Cost: $145.42/claim|Median: $121.16
1.2× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$1.6M

146K claims · 2.7%

Your Cost: $11.19/claim|Median: $37.81
0.3× median
99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$684K

78K claims · 1.1%

Your Cost: $8.81/claim|Median: $53.41
0.2× median
90834Normal range

Psychotherapy, 45 minutes

$429K

44K claims · 0.7%

Your Cost: $9.65/claim|Median: $63.65
0.2× median
59409Normal range

Vaginal delivery only

$381K

575 claims · 0.6%

Your Cost: $661.99/claim|Median: $619.91
1.1× median
90471Normal range

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$312K

36K claims · 0.5%

Your Cost: $8.72/claim|Median: $9.80
0.9× median
76817Normal range

Ultrasound, pregnant uterus, transvaginal

$141K

2,494 claims · 0.2%

Your Cost: $56.37/claim|Median: $47.65
1.2× median
90472Normal range

Immunization administration, each additional vaccine

$138K

19K claims · 0.2%

Your Cost: $7.32/claim|Median: $11.79
0.6× median
90686Normal range

Influenza virus vaccine, quadrivalent, preservative-free, IM

$136K

12K claims · 0.2%

Your Cost: $11.03/claim|Median: $7.18
1.5× median
99212Normal range

Office/outpatient visit, low complexity

$111K

12K claims · 0.2%

Your Cost: $8.98/claim|Median: $25.06
0.4× median
99173Top 25%

$104K

17K claims · 0.2%

Your Cost: $6.06/claim|Median: $2.16
2.8× median
99395Normal range

Preventive medicine, established patient, age 18-39

$98K

6,781 claims · 0.2%

Your Cost: $14.42/claim|Median: $72.71
0.2× median
90853Normal range

Group psychotherapy

$95K

6,154 claims · 0.2%

Your Cost: $15.50/claim|Median: $25.02
0.6× median
99392Normal range

Preventive medicine, established patient, age 1-4

$83K

11K claims · 0.1%

Your Cost: $7.43/claim|Median: $75.18
0.1× median
76830Normal range

Ultrasound, transvaginal

$80K

1,079 claims · 0.1%

Your Cost: $74.51/claim|Median: $57.47
1.3× median
81025Top 10%

Urine pregnancy test

$78K

7,847 claims · 0.1%

Your Cost: $9.89/claim|Median: $4.81
2.1× median
87880Normal range

Streptococcus, Group A, rapid antigen detection

$74K

5,499 claims · 0.1%

Your Cost: $13.54/claim|Median: $11.48
1.2× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$74K

10K claims · 0.1%

Your Cost: $7.16/claim|Median: $69.35
0.1× median
99393Normal range

Preventive medicine, established patient, age 5-11

$71K

8,064 claims · 0.1%

Your Cost: $8.78/claim|Median: $74.82
0.1× median
81002Top 25%

Urinalysis, non-automated without microscopy

$66K

23K claims · 0.1%

Your Cost: $2.80/claim|Median: $2.00
1.4× median
92551Normal range

Screening audiometry, pure tone, air only

$64K

14K claims · 0.1%

Your Cost: $4.49/claim|Median: $6.61
0.7× median
90670Normal range

$57K

5,963 claims · 0.1%

Your Cost: $9.64/claim|Median: $5.94
1.6× median
99396Normal range

Preventive medicine, established patient, age 40-64

$55K

1,720 claims · 0.1%

Your Cost: $31.85/claim|Median: $76.06
0.4× median
96372Normal range

Therapeutic injection, subcutaneous/intramuscular

$55K

5,276 claims · 0.1%

Your Cost: $10.37/claim|Median: $9.56
1.1× median
90832Normal range

Psychotherapy, 30 minutes

$52K

9,305 claims · 0.1%

Your Cost: $5.64/claim|Median: $41.28
0.1× median
87210Top 10%

$50K

5,339 claims · 0.1%

Your Cost: $9.40/claim|Median: $3.65
2.6× median
90633Normal range

$50K

5,130 claims · 0.1%

Your Cost: $9.74/claim|Median: $3.56
2.7× median
99394Normal range

Preventive medicine, established patient, age 12-17

$48K

4,795 claims · 0.1%

Your Cost: $10.03/claim|Median: $80.15
0.1× median
90837Normal range

Psychotherapy, 60 minutes

$42K

4,822 claims · 0.1%

Your Cost: $8.79/claim|Median: $85.66
0.1× median
90791Normal range

Psychiatric diagnostic evaluation

$41K

1,229 claims · 0.1%

Your Cost: $33.01/claim|Median: $99.21
0.3× median
90698Normal range

$41K

3,392 claims · 0.1%

Your Cost: $11.95/claim|Median: $6.32
1.9× median
90715Normal range

Tdap vaccine

$39K

3,231 claims · 0.1%

Your Cost: $12.05/claim|Median: $10.32
1.2× median
90680Normal range

$33K

4,024 claims · 0.1%

Your Cost: $8.25/claim|Median: $5.58
1.5× median
90474Top 25%

$33K

2,071 claims · 0.1%

Your Cost: $15.76/claim|Median: $8.42
1.9× median
76805Normal range

Ultrasound, pregnant uterus, complete, single fetus

$32K

403 claims · 0.1%

Your Cost: $80.04/claim|Median: $74.78
1.1× median
90744Top 25%

$30K

2,491 claims · 0.0%

Your Cost: $11.91/claim|Median: $5.00
2.4× median
99238Normal range

Hospital discharge day management, 30 minutes or less

$29K

628 claims · 0.0%

Your Cost: $46.65/claim|Median: $37.22
1.3× median
76816Normal range

Ultrasound, pregnant uterus, follow-up

$29K

496 claims · 0.0%

Your Cost: $58.92/claim|Median: $58.55
1.0× median
59025Normal range

Fetal non-stress test

$27K

1,737 claims · 0.0%

Your Cost: $15.28/claim|Median: $26.45
0.6× median
90710Normal range

MMRV vaccine

$26K

3,424 claims · 0.0%

Your Cost: $7.63/claim|Median: $7.00
1.1× median
90651Normal range

HPV vaccine, 9-valent

$24K

2,810 claims · 0.0%

Your Cost: $8.41/claim|Median: $8.93
0.9× median
90734Normal range

$20K

1,625 claims · 0.0%

Your Cost: $12.61/claim|Median: $6.40
2.0× median
59514Normal range

Cesarean delivery only

$19K

54 claims · 0.0%

Your Cost: $355.52/claim|Median: $452.80
0.8× median
90700Top 25%

$19K

1,301 claims · 0.0%

Your Cost: $14.72/claim|Median: $4.56
3.2× median
J1050Normal range

Injection, medroxyprogesterone acetate, one milligram

$18K

1,088 claims · 0.0%

Your Cost: $16.18/claim|Median: $41.92
0.4× median
99232Top 25%

Subsequent hospital care, per day, moderate complexity

$18K

384 claims · 0.0%

Your Cost: $45.83/claim|Median: $23.99
1.9× median
90792Normal range

Psychiatric diagnostic evaluation with medical services

$18K

1,248 claims · 0.0%

Your Cost: $14.07/claim|Median: $108.91
0.1× median
99215Normal range

Office/outpatient visit, high complexity

$14K

2,263 claims · 0.0%

Your Cost: $6.28/claim|Median: $74.09
0.1× median
99381Normal range

Preventive visit, new patient, infant (<1 yr)

$13K

1,217 claims · 0.0%

Your Cost: $11.03/claim|Median: $73.46
0.2× median
80305Normal range

$12K

1,264 claims · 0.0%

Your Cost: $9.70/claim|Median: $7.44
1.3× median

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