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

Why is the Medicaid comparison limited to Vermont 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. Vermont (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.

Northern Counties Health Care, Inc. (NPI 1003564931)

Field	Value
Entity Type	Organization
Organization	Northern Counties Health Care, Inc.
Address	137 Main St Ste 102
City	Newport
State	VT
ZIP	05855
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	March 10, 2022

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	6,490	$180	$1.2M
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	1,700	$20	$39.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	1,670	$10	$20K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	20	$30	$490
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	90	$1	$270
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	60	$1	$170
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	690	$0	$0
99203	The provider sees a new 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 provider…	2,300	$0	$0
99204	The provider sees a new 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 provider…	10	$0	$0
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…	3,400	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Vermont Distribution

Northern Counties Health Care, Inc. — 0 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. Vermont median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	42	70	11,650	$150	$3.3M
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…	79	320	760	$20	$88.2K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	49	50	1,020	$20	$87.6K
99204	The provider sees a new 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 provider…	44	50	50	$80	$50K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	3	10	60	$40	$45.1K
99203	The provider sees a new 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 provider…	3	70	70	$50	$36K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	7	50	250	$10	$7.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	57	80	190	$1	$3.7K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	8	20	80	$1	$720
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	9	40	280	$1	$60

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northern Counties Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Counties Health Care, Inc.	VT	Dental Clinic/Center	$0	$4.5M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.4M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$3.4M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.5M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.1M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.3M
June Goodband	VT	Mental Health Counselor	$0	$145.5K
Krystal-lynn Baptiste	VT	Mental Health Counselor	$0	$99.3K
Amanda Cushing	VT	Clinical Social Worker	$25K	$54.4K

Nearby Providers

Other providers in the same ZIP code as Northern Counties Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Kingdom Human Services Inc Ds Waiver	VT	Developmental Disabilities Clinic/Center	$0	$204.7M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$85.8K	$17.6M
Northeast Kingdom Human Services Inc Sbs	VT	Adolescent and Children Mental Health Clinic/Center	$0	$8.3M
Autism Advocacy And Intervention, LLC	VT	Behavior Analyst	$0	$7.8M
Newport Ambulance Service Inc.	VT	Land Ambulance	$743.2K	$2.9M
North Country Hospital & Health Center Inc	VT	Internal Medicine Physician	$0	$3.2M
North East Kingdom Community Action, Inc.	VT	Public Health or Welfare Agency	$0	$2.8M
Northeast Kingdom Human Services Inc Mh Children	VT	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
North Country Hospital & Health Center Inc	VT	Pediatrics Physician	$0	$2.2M
James V. Wyllie, Dds P.C.	VT	General Practice Dentistry	$0	$1.8M

Northern Counties Health Care, Inc. — Billing Profile & Reimbursement Data

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Northern Counties Health Care, Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References