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NPI 1104870922 · West Pawlet, VT · Family Medicine Physician
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Community Health Centers Of The Rutland Region, Inc. is a family medicine physician provider located in West Pawlet, Vermont. This profile covers 0 Medicare and 25 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Community Health Centers Of The Rutland Region, Inc. |
| Address | 278 Vt Route 149 |
| City | West Pawlet |
| State | VT |
| ZIP | 05775 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | May 19, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $3.8M |
| Medicare | $0 |
This provider reports no Medicare billing on file and $3.8M in lifetime Medicaid revenue, making its billed activity effectively single‑payer Medicaid‑focused at the aggregate level. The NPI was enumerated on 2006-05-19 (~20 years ago), indicating an established multi‑year presence in the market rather than a recent entrant.
Revenue is highly concentrated: the precomputed top 3 Medicaid codes by revenue account for 96.1% of this provider's total Medicaid revenue, so a very large share of cashflow depends on a narrow set of encounter/E/M and clinic visit codes. This concentration creates sensitivity to reimbursement or utilization shifts for those few codes.
The code mix is consistent with a high‑volume, clinic‑based primary care operation: T1015 (Clinic visit/encounter, all‑inclusive) drives the largest share with $2.7M revenue from 16.8K claims at $164 avg paid/claim, and two E/M codes 99213 ($511.9K, 13.3% of Medicaid revenue) and 99214 ($430K, 11.2% of Medicaid revenue) account for the next largest shares. Together these codes imply the provider delivers predominantly face‑to‑face outpatient primary care for established patients and bills both bundled clinic encounters and standard E/M visits.
Despite T1015 accounting for 71.6% of Medicaid revenue, the provider’s state market position on that code is modest — T1015 ranks #29 of 70 providers in‑state (59th percentile; labeled typical, unremarkable volume). In other words, T1015 is the dominant revenue driver for this practice but the provider is not an outlier statewide on that specific clinic visit metric.
By contrast the provider shows above‑typical statewide volume for E/M work: 99213 ranks #32 of 319 providers in‑state (90th percentile) and 99214 ranks #28 of 323 providers in‑state (92th percentile), signaling relatively strong throughput on established‑patient office visits compared with most in‑state peers. These high percentiles suggest the practice is an important local source of routine outpatient E/M visits despite being modest on the bundled clinic‑visit metric.
0241U is a statistical standout: 696 claims produced $94K revenue (2.4% of Medicaid revenue) and the provider ranks #1 of 8 in‑state (100th percentile; notably above typical state volume for this code). Although 0241U is a small share of total revenue, its top rank indicates a distinct specialty activity or service line where this provider is unusually active relative to peers.
The billing detail shows ancillary primary care services present but of small revenue impact: immunization codes (90460, 90471, 90686), point‑of‑care and lab testing codes (87635, 87637, 87804), and basic procedures like 36415 appear with modest revenue contributions. Behavioral health codes (90837, 90832, 90791) also appear in the file but with very low or zero paid revenue, suggesting either limited mental‑health throughput or different billing pathways for those services.
Operational implication: with roughly 96.1% of Medicaid revenue concentrated in T1015 plus 99213/99214 and no Medicare billing, this entity operates as a Medicaid‑dependent primary care clinic with established tenure (NPI since 2006-05-19). The presence of G0467 (FQHC visit) claims at low volume ($7.7K) indicates occasional use of FQHC‑style bundled billing in Medicaid, but that line is not a major revenue driver relative to T1015 and E/M work.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
25 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 16,760 | $160 | $2.7M |
| 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… | 13,830 | $40 | $511.9K |
| 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… | 9,770 | $40 | $430K |
| 0241U | N/A | 700 | $140 | $94K |
| 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. | 950 | $20 | $14.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 1,900 | $10 | $9.5K |
| 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… | 430 | $20 | $7.7K |
| 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… | 110 | $60 | $6.5K |
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 560 | $10 | $5K |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 10 | $150 | $2.1K |
Showing 1–10 of 25
How this provider's Medicaid billing volume and revenue compare to other Vermont providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Vermont median
25 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| T1015 | Clinic visit/encounter, all-inclusive | 29 | 70 | 11,650 | $150 | $3.3M |
| 87637 | The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)… | 8 | 10 | 160 | $120 | $149.2K |
| 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… | 28 | 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… | 228 | 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… | 32 | 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… | 32 | 50 | 1,020 | $20 | $87.6K |
| 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. | 22 | 40 | 890 | $10 | $32.1K |
| 90832 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 85 | 110 | 260 | $20 | $19.5K |
| 87804 | The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings. | 16 | 20 | 170 | $10 | $17.3K |
| 99393 | The provider performs an established well–patient visit for a child who is between the ages of 5 and 11. | 43 | 40 | 290 | $20 | $16K |
Showing 1–10 of 25
Other providers in the same ZIP code as Community Health Centers Of The Rutland Region, Inc., ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Carl Beckler | VT | Family Medicine Physician | $9.6K | $0 |
| Jean Letts | VT | Internal Medicine Physician | $3.6K | $0 |
| Job Larson | VT | Family Medicine Physician | $3.2K | $0 |
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