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.

Battenkill Valley Health Center, Inc (NPI 1033530696)

Field	Value
Entity Type	Organization
Organization	Battenkill Valley Health Center, Inc
Address	9 Church St
City	Arlington
State	VT
ZIP	05250
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	December 30, 2013

Payer Source	Total Paid
Medicaid	$3.7M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-centric operation: there is no Medicare billing on file and total Medicaid revenue is $3.7M, indicating near‑exclusive reliance on Medicaid reimbursement rather than a split payer mix. The NPI was enumerated on 2013-12-30 (~13 years ago), so this is an established FQHC practice with a Medicaid-dominant revenue base.

Revenue is highly concentrated in a single code family: T1015 (Clinic visit/encounter, all-inclusive) generates $3M in revenue and represents 79.5% of this provider’s Medicaid revenue, and the precomputed top three Medicaid codes together account for 88.2% of total Medicaid revenue. This indicates a reliance on bundled clinic visit payments for the bulk of financials.

The code mix and descriptions point to an FQHC-style primary care and integrated dental model: T1015 (clinic visit/encounter) is the dominant revenue driver, while dental preventive and restorative codes such as D1110 ($188.2K, 5.0%), D0120 ($111.1K, 3.0%), D2392 ($135.6K, 3.6%) and D1120 ($75.1K, 2.0%) together create a measurable dental service footprint within the Medicaid revenue stream. This combination aligns with an FQHC that provides both primary medical encounters and on-site dental services.

Despite the large share of revenue coming from T1015, the provider’s statewide competitive standing on that code is modest: T1015 ranks #27 of 70 providers in-state (62th percentile; typical, unremarkable volume for this code). In other words, the practice depends heavily on that bundled visit revenue but is not a dominant statewide volume leader for the code.

Certain dental preventive codes show stronger relative presence versus peers: D1110 ranks #16 of 150 providers in-state (90th percentile; typical, unremarkable volume) and D0120 ranks #24 of 156 providers in-state (85th percentile; typical, unremarkable volume), indicating above-typical state-level activity in prophylaxis and periodic oral evaluations even if total dollar contribution remains far below T1015. D2392 (post 2 surface composite) ranks #21 of 59 (66th percentile; typical, unremarkable volume), signaling modest restorative activity.

There are noticeable mismatches between claim volume and paid revenue for some codes: 99213 has 5.6K claims with $1 avg paid/claim ($5.6K revenue) and 99214 has 3K claims with $1 avg paid/claim ($3K revenue), while 90837 shows 2.6K claims with $0 revenue. These patterns reflect substantial claim activity for E/M and behavioral codes that contribute minimal Medicaid dollars to the overall revenue mix.

One statistical outlier in the dataset is 99442, which ranks #2 of 20 providers in-state (95th percentile; notably above typical state volume for this code). Although the data list provides no description for 99442 here, the unusually high rank signals above-typical use of this particular service relative to other in-state providers and warrants follow-up if you are evaluating service delivery channels.

Operationally, the combination of a dominant T1015 revenue stream, a cluster of dental codes accounting for secondary revenue, and several high-claim/low-payment E/M/behavioral lines suggests a care model that bills bundled clinic encounters as the financial backbone while maintaining breadth of services (medical, dental, behavioral) typical of an FQHC. The fiscal profile is therefore concentrated in a single bundled outpatient code with supplementary but much smaller dental and ancillary service revenues.

Medicaid: Complete Services Breakdown

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

34 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	17,130	$170	$3M
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3,620	$50	$188.2K
D2392	Post 2 surface resin‑based composite	1,050	$130	$135.6K
D0120	Periodic oral evaluation - established patient	3,970	$30	$111.1K
D1120	Prophylaxis–child	1,980	$40	$75.1K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	2,880	$20	$60.4K
D0274	N/A	1,550	$30	$52.8K
D2391	Resin‑based composite – one surface, posterior	590	$80	$47.5K
D0150	Comprehensive oral evaluation – new or established patient	700	$40	$24.4K
D0140	Limited oral evaluation – problem focused	490	$40	$17.5K

Showing 1–10 of 34

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

Battenkill Valley Health Center, Inc — 0 of 24 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

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	27	70	11,650	$150	$3.3M
D2392	Post 2 surface resin‑based composite	21	60	610	$130	$155.6K
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…	83	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…	162	670	760	$70	$143.9K
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…	57	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…	48	50	1,020	$20	$87.6K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	16	150	540	$50	$73.5K
D1351	Sealant - per tooth	28	40	480	$20	$63.9K
D2391	Resin‑based composite – one surface, posterior	20	50	310	$90	$62.9K
D1120	Prophylaxis–child	22	110	220	$40	$59.2K

Showing 1–10 of 34

Related Providers

Other providers that share a Tax Identification Number (TIN) with Battenkill Valley Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Walter Griffiths	VT	Geriatric Medicine (Internal Medicine) Physician	$38.9K	$28.1K
Leigh Lopresti	VT	Family Medicine Physician	$33.4K	$0
Jamie Rogers	VT	Primary Care Nurse Practitioner	$28K	$0

Nearby Providers

Other providers in the same ZIP code as Battenkill Valley Health Center, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arlington Rescue Squad Inc.	VT	Land Ambulance	$93.5K	$14K
Denise Olin	VT	Clinical Psychologist	$89.5K	$0
Paula Shulman	VT	Clinical Social Worker	$0	$58.1K
Jill Egbert, Licsw, PLLC	VT	Adult Mental Health Clinic/Center	$0	$54.2K
Jill Egbert	VT	Clinical Social Worker	$32.6K	$3.2K

Battenkill Valley Health Center, Inc — Billing Profile & Reimbursement Data

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Battenkill Valley Health 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