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.

Little Rivers Health Care, Inc. (NPI 1033163555)

Field	Value
Entity Type	Organization
Organization	Little Rivers Health Care, Inc.
Address	437 S Main St
City	Bradford
State	VT
ZIP	05033
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	May 20, 2006

Payer Source	Total Paid
Medicaid	$114.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	310	$160	$48K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	480	$60	$27.1K
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…	1,830	$10	$20.2K
99443	N/A	80	$100	$8.1K
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…	230	$20	$3.9K
87631	The lab analyst performs the technical steps to detect three to five types or subtypes of pathogens, such as adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus,…	20	$130	$1.9K
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…	50	$30	$1.4K
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.	100	$10	$1.1K
99442	N/A	20	$70	$1.1K
90682	This code represents a quadrivalent flu vaccine given by injection into the muscle. The vaccine is made using recombinant DNA technology and contains only a protein from the virus. It does not…	40	$20	$920

Showing 1–10 of 16

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

Little Rivers Health Care, Inc. — 0 of 12 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	59	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…	268	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…	281	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…	39	50	1,020	$20	$87.6K
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…	9	10	60	$40	$45.1K
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.	32	40	890	$10	$32.1K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	5	20	180	$40	$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…	6	30	720	$10	$14.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	87	110	150	$10	$4.6K
99443	N/A	13	20	120	$20	$3.1K

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Little Rivers Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$12.1M
Sarah Metz	VT	Clinical Social Worker	$0	$110.4K
Little Rivers Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$69.5K
Maureen Boardman	VT	Nurse Practitioner	$2.3K	$0
Patricia Pratt	VT	Internal Medicine Physician	$750	$0
Rachel Morse	VT	Family Nurse Practitioner	$460	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Oas, LLC	VT	Children's Substance Abuse Rehabilitation Facility	$0	$30.6M
Upper Valley Pediatrics, PLLC	VT	Pediatric Adolescent Medicine Physician	$0	$1.8M
Heidi Nostrant	VT	Clinical Psychologist	$0	$215.1K
Robert Munson	VT	General Practice Dentistry	$0	$189.9K
Sinclair Chiropractic Clinic PC	VT	Chiropractor	$0	$96.1K
Barry Waterson	VT	Clinical Psychologist	$71.3K	$0
Kph Healthcare Services, Inc.	VT	Community/Retail Pharmacy	$68.1K	$0
Visionary Eye Associates LLC	VT	Optometrist	$0	$61.7K
Martins Foods Of South Burlington LLC	VT	Community/Retail Pharmacy	$56.9K	$0
Bradford Optical, Plc	VT	Optometrist	$0	$55.9K

Little Rivers Health Care, Inc. — Billing Profile & Reimbursement Data

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Little Rivers 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