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.

Candice Ortiz (NPI 1093814139)

Field	Value
Entity Type	Individual
Organization	Candice Ortiz
Address	1315 Hospital Dr
City	St Johnsbury
State	VT
ZIP	05819
Taxonomy	Diagnostic Radiology Physician
NPI Enumerated	September 22, 2006

Payer Source	Total Paid
Medicare	$161K
Medicaid	$0

Key Findings

CANDICE ORTIZ (Diagnostic Radiology Physician) is enumerated in NPI records since 2006-09-22 (~20 years ago) and has a lifetime Medicare revenue footprint of $161K. There is no Medicaid billing on file (none below), so the provider operates with an effectively single-payer Medicare billing profile rather than a dual Medicare/Medicaid mix.

The provider’s top-revenue services are concentrated in cross-sectional and breast imaging: 74177 (CT abdomen/pelvis with contrast), 77067 (screening mammography), and 77063 (tomosynthesis). This mix indicates a practice offering advanced CT and breast imaging capabilities alongside more general diagnostic studies, consistent with a diagnostic radiology service line that handles both high-acuity CT studies and routine screening mammography.

Revenue concentration is meaningful but not extreme: the precomputed top-3 Medicare codes account for 35.8% of total Medicare revenue. Those three codes are 74177 ($20.2K, 15.8%), 77067 ($14.2K, 11.1%), and 77063 ($11.4K, 8.9%), showing the largest single-code driver is 74177 while mammography (2D and tomosynthesis) together are also material to the revenue mix.

Competitive standing on key CT and mammography codes is modest: 74177 ranks #2035 of 23621 providers nationally (91th percentile; typical, unremarkable volume for this code), while 77067 ranks #5042 of 15198 (67th percentile; typical, unremarkable volume) and 77063 ranks #4770 of 14277 (67th percentile; typical, unremarkable volume). These placements suggest the provider is above many peers on its top CT code but is not operating as a specialized, very high-volume center in these categories.

Several plain radiography and extremity imaging codes are statistical outliers on the high side, indicating unusually strong throughput in general X-ray services. Examples include 73030 with 402 claims ($7 avg paid/claim, $2.8K revenue) ranked #502 of 34809 (99th percentile; notably above typical national volume), 73564 with 269 claims ($9 avg paid/claim, $2.4K revenue) ranked #967 of 20494 (95th percentile; notably above typical national volume), 73502 with 304 claims ($7 avg paid/claim, $2.1K revenue) ranked #766 of 33225 (98th percentile; typical, unremarkable volume), and 73630 with 254 claims ($6 avg paid/claim, $1.5K revenue) ranked #1633 of 30788 (95th percentile; notably above typical national volume).

Operationally the practice shows a two-tier pattern: a smaller number of higher-reimbursement cross-sectional studies (CT and MRI) combined with a high volume of low-reimbursement radiographs. For example, chest radiographs 71046 appear with 494 claims ($7 avg paid/claim, $3.5K revenue) and 71045 with 399 claims ($6 avg paid/claim, $2.4K revenue), highlighting reliance on high-claim-count, low-dollar procedures to supplement revenue.

Payer concentration risk is notable because Medicaid is absent: with $161K total Medicare revenue and no Medicaid claims on file, the provider’s public-payer exposure is concentrated entirely in Medicare. Analysts should treat this as effectively single-payer Medicare exposure when assessing reimbursement risk, access to Medicaid populations, or negotiations with payers.

Taken together—~20 years of enrollment, $161K lifetime Medicare revenue, a 35.8% concentration in the top three codes, and very high percentile ranks on several plain radiography codes—the profile is consistent with an established diagnostic radiology practice that delivers a broad mix of imaging (CT, MRI, mammography, and high-throughput X-ray) but operates at modest Medicare revenue scale compared with large radiology groups or imaging centers.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

79 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	330	$60	$20.2K
77067	The provider takes two X–ray views of each breast for routine screening and may use specially designed computer software to help identify any potential abnormalities within the images; the software…	410	$40	$14.2K
77063	The provider captures three dimensional images of the breast using X–rays at various angles for routine checkup. He checks for the presence of any abnormality within the breasts. Tomosynthesis…	410	$30	$11.4K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	350	$30	$9.9K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	200	$40	$7.6K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	130	$60	$7.5K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	90	$60	$5.8K
70551	The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam.	90	$50	$4.3K
70496	The provider injects contrast material into a peripheral vein and images the blood vessels in the patient's head using computed tomographic scanning. Noncontrast images, if performed, are included in…	70	$60	$3.8K
70498	The provider injects contrast material into a peripheral vein and images the blood vessels in the patient's neck using computed tomographic scanning. Noncontrast images, if performed, are included in…	70	$60	$3.8K

Showing 1–10 of 79

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 79 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Vermont Distribution

Candice Ortiz — 3 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. state median

79 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
77067	18	30	450	$40	$19.4K
77063	18	30	450	$30	$15K
74177	5	40	140	$60	$10.9K
70450	10	30	190	$30	$7.7K
70553	16	30	50	$90	$6.6K
72148	14	30	80	$60	$5.6K
71260	7	30	80	$40	$4.8K
71250	17	30	100	$40	$4.1K
71275	8	30	40	$60	$4K
74176	5	40	60	$60	$3.9K

Showing 1–10 of 79

Related Providers

Other providers that share a Tax Identification Number (TIN) with Candice Ortiz, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Vermont Radiologists	VT	Diagnostic Radiology Physician	$0	$795.5K
Vermont Open Mri	VT	Magnetic Resonance Imaging (MRI) Clinic/Center	$130.4K	$59.2K
Robert Smith	VT	Diagnostic Radiology Physician	$154K	$0
Joseph Pekala	VT	Diagnostic Radiology Physician	$106.6K	$0
James Graham	NH	Diagnostic Radiology Physician	$96.2K	$0
Paul Anderson	MT	Vascular & Interventional Radiology Physician	$83.6K	$0
Eugene Moore	VT	Internal Medicine Physician	$62.9K	$0
Joseph Lambert	KY	Diagnostic Radiology Physician	$36.9K	$0
James Mcglinn	VT	Chiropractor	$36.8K	$0
Mark Pitcher	VT	Internal Medicine Physician	$10.5K	$0

Nearby Providers

Other providers in the same ZIP code as Candice Ortiz, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Darren Boles Dds PLLC	VT	Dental Clinic/Center	$0	$5.2M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$559K	$3.5M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$3.4M
Northeastern Vermont Regional Hospital, Inc	VT	Primary Care Clinic/Center	$0	$2.8M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.5M
Caledonia-essex Area Ambulance Service, Inc.	VT	Land Ambulance	$406.4K	$1.6M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Northeastern Vermont Regional Hospital, Inc	VT	Rural Health Clinic/Center	$0	$1.3M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.3M
Jason Parks	VT	Radiation Oncology Physician	$1.2M	$0

Candice Ortiz — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References