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.

Central Vermont Medical Center Inc (NPI 1023028784)

Key Findings

Field	Value
Entity Type	Organization
Organization	Central Vermont Medical Center Inc
Address	130 Fisher Rd
City	Berlin
State	VT
ZIP	05602
Taxonomy	Family Medicine Physician
NPI Enumerated	August 8, 2006

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

This provider is effectively single‑payer on file: there is no Medicare billing on file while total Medicaid revenue is $4.1M. The NPI was enumerated on 2006-08-08 (~20 years ago), indicating long tenure in the market that likely supports established referral and patient panels tied to Medicaid billing patterns.

Revenue is highly concentrated in a very small set of codes: the top three Medicaid codes (99214, 99213, 99284) account for 77.1% of this provider's total Medicaid revenue. The largest single line is 99214 with $1.7M (41.3% of Medicaid revenue), followed by 99213 at $1.2M (30.6%), and 99284 at $209.4K (5.2%), signaling that most income derives from a narrow set of E/M services.

The code mix indicates a primary care–centered outpatient operation with significant established‑patient volume: 99214 (72K claims, $23 avg paid/claim, $1.7M) and 99213 (72.2K claims, $17 avg paid/claim, $1.2M) dominate revenue and represent routine evaluation and management visits for established patients. These volumes and the code descriptions suggest day‑to‑day operations are driven by ambulatory chronic care and routine follow‑up, with substantial time/decision‑making invested in established patient encounters.

Emergency department and higher‑acuity E/M services are present but make up a much smaller share of revenue: 99284 (9.5K claims, $22 avg paid/claim, $209.4K, 5.2%) and related ED codes such as 99285 (3.2K claims, $27 avg paid/claim, $86.4K) appear in the top list but do not approach the financial weight of primary care E/M. State ranking for 99284 is #7 of 31 (80th percentile), indicating typical ED volume rather than a dominant emergency services footprint.

Preventive care and pediatric services are visible alongside vaccinations: 99391 ($108.6K, 2.7%) and 99392/99393 appear in the top codes, while vaccine administration codes 90460 (5.6K claims, $67.7K, 1.7%) and 90471 (9.9K claims, $39.7K, 1.0%) show the provider delivers routine immunizations and well visits. These items support a mixed ambulatory practice that includes age‑based preventive medicine and pediatric vaccination throughput.

Behavioral health is integrated into the service mix, with psychotherapy and psychotherapy add‑on codes appearing in the top claims: 90837 ($118.5K, 3.0%), 90833 ($65.9K, 1.6%), and 90834/90832 also reported. Notably, 90833 ranks #2 of 39 providers in‑state (97th percentile; notably above typical state volume), implying above‑average use of E/M plus psychotherapy blend in some clinical encounters.

On competitive standing within Vermont Medicaid, the provider is a major statewide player for core primary care E/M codes: both 99214 and 99213 rank #4 (of 323 and 319 respectively) and sit in the 99th percentile labeled as "extreme outlier," reflecting volumes far above typical in‑state peers for those codes. For several ancillary codes (e.g., 99215 rank #4 of 111, 97th percentile; 90471 rank #4 of 88, 97th percentile) the provider also ranks notably high, reinforcing a leading role in ambulatory primary and preventive services.

The narrow revenue base creates operational concentration risk: with 77.1% of Medicaid revenue coming from the top three codes, changes in Medicaid reimbursement, coding rules, or utilization for 99214/99213/99284 would materially affect overall revenue. Combined with the absence of Medicare billing on file, the provider's financial exposure is concentrated into Medicaid policy and utilization trends rather than diversified across payers.

Medicaid: Complete Services Breakdown

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

100 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	72,010	$20	$1.7M
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…	72,240	$20	$1.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	9,520	$20	$209.4K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	7,410	$20	$118.5K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	1,530	$70	$108.6K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	3,200	$30	$86.4K
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…	2,840	$30	$79.5K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	5,640	$10	$67.7K
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	3,880	$20	$65.9K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	4,510	$10	$49.6K

Showing 1–10 of 100

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

Central Vermont Medical Center Inc — 5 of 25 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

100 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	7	30	830	$40	$232.2K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	9	30	1,150	$30	$147K
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…	4	320	680	$30	$146.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	40	670	760	$70	$143.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	15	20	630	$30	$118.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	5	30	190	$50	$104.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4	10	510	$40	$103.2K
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…	4	320	760	$20	$88.2K
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…	14	50	50	$80	$50K
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…	4	110	170	$70	$38.6K

Showing 1–10 of 100

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dean Stephens	GA	Rheumatology Physician	$2.7M	$0
Central Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$907.7K
Central Vermont Medical Center Inc	VT	General Acute Care Hospital	$0	$223.3K
Kimberly Jordan	MN	Diagnostic Radiology Physician	$215.2K	$0
Daniel Wilson	VT	Emergency Medicine Physician	$86.9K	$116.4K
Gregory Kenyherz	MN	Diagnostic Radiology Physician	$135.2K	$0
Russell Meyer	VT	Diagnostic Radiology Physician	$126.6K	$0
Hill Enuh	IN	Pulmonary Disease Physician	$120.9K	$0
Michael Bazylewicz	VT	Neuroradiology Physician	$117.6K	$0
Charles Pappas	VT	Diagnostic Radiology Physician	$115K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Mental Health Services, Inc.	VT	Community/Behavioral Health Agency	$0	$99.3M
Washington County Family Center	VT	Developmentally Disabled Services Day Training Agency	$0	$6.7M
Treatment Associates, Inc	VT	Mental Health Counselor	$0	$6.2M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$202.1K	$2.8M
Benjamin Newman	VT	Clinical Social Worker	$0	$1.5M
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$678.6K
M Gould	VT	Psychologist	$0	$574.9K
City Of Montpelier Ambulance	VT	Land Ambulance	$190.7K	$378.7K
John Lansky	VT	General Practice Dentistry	$0	$466.9K
Gabriel Archdeacon	VT	Naturopath	$0	$464.9K

Central Vermont Medical Center Inc — Billing Profile & Reimbursement Data

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Central Vermont Medical Center Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References