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.

Northern Counties Health Care, Inc. (NPI 1114044344)

Field	Value
Entity Type	Organization
Organization	Northern Counties Health Care, Inc.
Address	151 North Main Street
City	Hardwick
State	VT
ZIP	05843
Taxonomy	Dental Clinic/Center
NPI Enumerated	March 23, 2007

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

Key Findings

NORTHERN COUNTIES HEALTH CARE, INC. appears to operate primarily as a high-volume dental clinic focused on preventive and routine restorative services, based on its top Medicaid codes which include D1110 (Prophylaxis - adult), D0120 (Periodic oral evaluation - established patient), D1120 (Prophylaxis–child), and D1206 (Topical Fluoride Treatment). The presence of large claim counts for cleanings, evaluations, fluoride, and sealants indicates an emphasis on scheduled preventive care and school- or community-based pediatric dentistry rather than specialty surgical or prosthetic services.

This provider’s Medicaid revenue is $4.5M and there is no Medicare billing on file, indicating an effectively single-payer Medicaid practice with no measurable Medicare participation. That payer concentration implies the organization’s patient mix and operational footprint are strongly Medicaid-centric, which will shape contract negotiations and network value primarily for Medicaid managed care plans.

Revenue is concentrated in a small set of Medicaid codes: the top 3 Medicaid codes by revenue account for 45.1% of the provider’s total Medicaid revenue. Those top codes are dominated by prophylaxis and evaluation services, so a large share of the provider’s revenue base depends on routine preventive visits rather than higher-dollar complex procedures.

NORTHERN COUNTIES is a statewide volume leader on several preventive codes: it ranks #1 of 150 for D1110 (100th percentile, described as an extreme outlier) and ranks in the top 2 for D0120 and D1120 (99th percentile, extreme outliers). These ranks indicate the clinic is a dominant provider in Vermont for adult and child prophylaxis and periodic evaluations, significantly outpacing most in-state peers on these services.

Several other codes also show notably high in-state volumes: D1206 and D0274 rank #2 in-state at the 99th percentile (characterized as extreme outliers), and codes such as D2392, D1351, D2391 and D0140 rank in the ~90th percentile or above (notably above typical state volume). This mix suggests the clinic pairs high-volume preventive care with routine restorative work (resin-based composites and two-surface restorations) at scale.

Some procedure lines are less prominent: extractions (D7140) and comprehensive new-patient exams (D0150) generate modest shares of revenue (2.8% and 1.8% respectively) and rank in middle-to-high percentiles that are described as typical or unremarkable for the state. This pattern reinforces that the clinic’s throughput is weighted toward preventive maintenance and limited restorative care rather than complex oral surgery.

The provider’s NPI has been enumerated since 2007-03-23 (~19 years ago), indicating long tenure in the market. That longevity combined with extreme outlier volume on multiple preventive codes suggests an established operational model and likely deep integration with local Medicaid pediatric and adult dental programs.

Statistically, the dataset labels for this provider include several “extreme outlier” and “notably above typical” flags for key preventive codes; taken together these labels signify that NORTHERN COUNTIES is an exceptionally high-volume deliverer of routine dental services in Vermont Medicaid compared with peers. For payers and network planners, the provider represents a concentrated source of preventive dental capacity that could be important for access in its service area.

Medicaid: Complete Services Breakdown

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
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	19,050	$50	$971.3K
D0120	Periodic oral evaluation - established patient	20,860	$30	$542.4K
D1120	Prophylaxis–child	13,900	$40	$528.3K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	23,280	$20	$488.9K
D2392	Post 2 surface resin‑based composite	3,210	$130	$411.3K
D0274	N/A	9,500	$30	$303.9K
D1351	Sealant - per tooth	9,700	$20	$232.8K
D2391	Resin‑based composite – one surface, posterior	2,560	$90	$227.8K
D0140	Limited oral evaluation – problem focused	4,680	$40	$187.1K
D0330	N/A	2,740	$60	$169.8K

Showing 1–10 of 25

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

Northern Counties Health Care, Inc. — 5 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7210	Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of…	16	20	770	$140	$185K
D2392	Post 2 surface resin‑based composite	6	60	610	$130	$155.6K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	12	50	400	$80	$101.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	1	150	540	$50	$73.5K
D1351	Sealant - per tooth	4	40	480	$20	$63.9K
D2391	Resin‑based composite – one surface, posterior	5	50	310	$90	$62.9K
D1120	Prophylaxis–child	2	110	220	$40	$59.2K
D0120	Periodic oral evaluation - established patient	2	160	720	$30	$57.8K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	2	120	500	$20	$53.5K
D0140	Limited oral evaluation – problem focused	5	70	560	$40	$53.3K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northern Counties Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$4.4M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$3.4M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.5M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.1M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.3M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.2M
June Goodband	VT	Mental Health Counselor	$0	$145.5K
Krystal-lynn Baptiste	VT	Mental Health Counselor	$0	$99.3K
Amanda Cushing	VT	Clinical Social Worker	$25K	$54.4K

Nearby Providers

Other providers in the same ZIP code as Northern Counties Health Care, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kathleen Landry	VT	Mental Health Counselor	$0	$863.7K
Tracy Ulrich	VT	Mental Health Counselor	$0	$687.6K
Randolph Bulpin	VT	Mental Health Counselor	$0	$652K
Larry Karp	VT	Clinical Psychologist	$0	$452.3K
Wellspring Multidisciplinary Health And Education Project Inc	VT	Psychologist	$0	$416.4K
Colleen Kutin	VT	Clinical Social Worker	$0	$240K
Hardwick Emergency Rescue Squad, Inc.	VT	Ambulance	$126.9K	$93.1K
Talaia Thomas	VT	Mental Health Counselor	$0	$186.6K
Drex Wright	VT	Mental Health Counselor	$0	$172.3K
Whole Family Wellness, Inc.	VT	Naturopath	$0	$156.9K

Northern Counties Health Care, Inc. — Billing Profile & Reimbursement Data

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Northern Counties Health Care, 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