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.

Springfield Hospital (NPI 1033225875)

Springfield Hospital is a critical access hospital clinic/center provider located in Springfield, Vermont. This profile covers 0 Medicare and 48 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	Springfield Hospital
Address	25 Ridgewood Road
City	Springfield
State	VT
ZIP	05156
Taxonomy	Critical Access Hospital Clinic/Center
NPI Enumerated	August 22, 2006

Payer Source	Total Paid
Medicaid	$960.1K
Medicare	$0

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

48 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	3,390	$70	$237.4K
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.	3,150	$70	$233.3K
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.	2,880	$80	$216.1K
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…	4,610	$10	$41.5K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	820	$40	$35K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	320	$110	$33.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	320	$100	$30.8K
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…	1,780	$10	$19.5K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	3,280	$10	$16.4K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	510	$30	$13.3K

Showing 1–10 of 48

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

Springfield Hospital — 2 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

48 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	6	10	660	$80	$1.5M
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	12	20	2,660	$50	$742.4K
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.	11	30	830	$40	$232.2K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	3	10	80	$30	$164.6K
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.	11	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…	117	320	680	$30	$146.1K
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…	16	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.	6	30	190	$50	$104.3K
87591	The lab analyst performs a lab test for Neisseria gonorrhoeae, also called GC, using amplified nucleic acid probe technique.	5	10	80	$30	$98.8K
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…	65	320	760	$20	$88.2K

Showing 1–10 of 48

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jose Ventura	ME	Family Medicine Physician	$50.9K	$197.8K
Joseph Zito	NY	Emergency Medicine Physician	$213.5K	$17.8K
Sassan Naderi	CA	Emergency Medicine Physician	$111.8K	$45.5K
Mukti Patel-prineas	CT	Family Medicine Physician	$144K	$0
Vitaliano Sicilia	NH	Internal Medicine Physician	$103.1K	$0
Jesper Brickley	VT	Family Medicine Physician	$95.8K	$0
Catherine Fernando	NH	Emergency Medicine Physician	$94.9K	$0
Anthony Campbell	MI	Surgery Physician	$77K	$0
Matthew Nofziger	VT	Orthopaedic Surgery Physician	$74.8K	$0
Springfield Hospital Inc	VT	Anesthesiology Physician	$0	$73.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$13.3M
Crissy Webster	VT	Mental Health Counselor	$0	$850.4K
Town Of Springfield	VT	Ambulance	$249.4K	$482K
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$683.8K
Twin State Psychological Services	VT	Psychologist	$0	$519.6K
Kathy-jo Merlau	VT	Mental Health Counselor	$0	$512K
Springfield Medical Care Systems Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$365.8K
Crissy Webster Counseling Services LLC	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$242.6K
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$204.8K
Vincent Buckholz	VT	Clinical Social Worker	$0	$202.6K

Springfield Hospital — Billing Profile & Reimbursement Data

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Springfield Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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