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.

Green Mountain Pediatrics PC (NPI 1073617783)

Green Mountain Pediatrics PC is a pediatrics physician provider located in Bennington, Vermont. This profile covers 0 Medicare and 45 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	Green Mountain Pediatrics PC
Address	901 Main Street
City	Bennington
State	VT
ZIP	05201
Taxonomy	Pediatrics Physician
NPI Enumerated	September 12, 2006

Payer Source	Total Paid
Medicaid	$287.9K
Medicare	$0

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

45 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…	1,450	$50	$66.9K
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…	1,560	$30	$53K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	1,010	$30	$33.5K
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.	1,630	$20	$32.5K
G9001	Coordinated care fee, initial rate	1,530	$20	$27.6K
99392	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…	220	$90	$20.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	260	$60	$15.3K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	270	$30	$7.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	640	$10	$6.4K
96161	The provider administers a questionnaire aimed at helping to identify a specific health risk to a patient's caregiver, analyzes the results, assigns a score, and documents the findings. Use this code…	4,960	$1	$5K

Showing 1–10 of 45

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

Green Mountain Pediatrics PC — 1 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

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	124	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…	115	320	760	$20	$88.2K
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.	17	40	890	$10	$32.1K
99392	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…	24	40	280	$20	$19.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	24	40	290	$20	$16K
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.	12	30	140	$10	$15.6K
G9001	Coordinated care fee, initial rate	4	20	230	$20	$15.6K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	5	40	210	$30	$13.7K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	18	30	360	$10	$11.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	33	90	330	$10	$10K

Showing 1–10 of 45

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Counseling Service Of Bennington County, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$72.5M
Vermont Permanency Initiative, Inc.	VT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$27.9M
Savida Health, PC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$12M
Sunrise Family Resource Center	VT	Social Worker	$0	$7M
Seall Inc	VT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$6.6M
United Counseling Service Of Bennington County, Inc.	VT	Clinic/Center	$0	$6M
Southwestern Vermont Medical Center Inc.	VT	General Acute Care Hospital	$0	$5.1M
Town Of Bennington Rescue Squad, Inc.	VT	Land Ambulance	$683.4K	$2.7M
Southwestern Vermont Medical Center Inc.	VT	Internal Medicine Physician	$0	$2.9M
Oral And Facial Surgery Associates,plc	VT	Oral and Maxillofacial Surgery (Dentist)	$0	$1.8M

Green Mountain Pediatrics PC — Billing Profile & Reimbursement Data

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Green Mountain Pediatrics PC — 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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