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.

Gifford Health Care, Inc (NPI 1013269430)

Gifford Health Care, Inc is a general practice physician provider located in Randolph, Vermont. This profile covers 0 Medicare and 23 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	Gifford Health Care, Inc
Address	44 South Main St.
City	Randolph
State	VT
ZIP	05060
Taxonomy	General Practice Physician
NPI Enumerated	October 9, 2012

Payer Source	Total Paid
Medicaid	$256.1K
Medicare	$0

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	5,020	$10	$70.3K
D0145	N/A	1,050	$30	$33.5K
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…	470	$70	$32.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,120	$10	$29.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	290	$100	$28.8K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	3,790	$10	$18.9K
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…	100	$130	$13.4K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	400	$30	$13.1K
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…	40	$100	$3.4K
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…	130	$30	$3.4K

Showing 1–10 of 23

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

Gifford Health Care, Inc — 0 of 19 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

23 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	46	70	11,650	$150	$3.3M
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…	290	320	680	$30	$146.1K
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…	186	320	760	$20	$88.2K
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…	64	110	170	$70	$38.6K
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…	108	170	360	$20	$35.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	10	20	1,990	$1	$20.9K
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.	15	30	140	$10	$15.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	3	30	720	$10	$14.5K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	12	40	210	$30	$13.7K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	19	30	160	$10	$10K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clara Martin Center	VT	Community/Behavioral Health Agency	$0	$11.8M
Clara Martin Center	VT	Community/Behavioral Health Agency	$0	$807.8K
Gifford Medical Center Inc.	VT	General Acute Care Hospital	$0	$218.4K
Shana Kotelchuck	VT	Clinical Social Worker	$0	$212.8K
Maxi Green Inc	VT	Community/Retail Pharmacy	$163.2K	$0
Resonant Medicine	VT	Naturopath	$0	$86.5K
Marjorie Crowe	VT	Clinical Social Worker	$27.7K	$51.2K
Soares Ocular Surgery	VT	Ophthalmologic Surgery Clinic/Center	$0	$63.9K
James Currie	VT	Internal Medicine Physician	$57.9K	$0
Dennis Gilroy	VT	Diagnostic Radiology Physician	$57K	$0

Gifford Health Care, Inc — Billing Profile & Reimbursement Data

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Gifford 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$8.4M
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$2M
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Gifford Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$935.6K
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$820.3K
Suzanne Carlisle Stebenne	VT	Family Nurse Practitioner	$8.8K	$717.9K
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$344.4K
Jessica Heney	VT	Family Medicine Physician	$0	$273.6K
Paula Despault	VT	Mental Health Counselor	$0	$151.9K
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$111.2K