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.

Barbara Spear (NPI 1114559531)

Field	Value
Entity Type	Individual
Organization	Barbara Spear
Address	289 County Rd
City	Windsor
State	VT
ZIP	05089
Taxonomy	Gerontology Clinical Nurse Specialist
NPI Enumerated	February 5, 2020

Payer Source	Total Paid
Medicare	$292K
Medicaid	$0

Key Findings

This provider is effectively a Medicare-focused clinician: lifetime Medicare revenue is $292K while there is no Medicaid billing on file, so BARBARA SPEAR operates as a single-payer (Medicare) biller in the available data rather than a mixed Medicare–Medicaid practice. Analysts should treat any Medicaid-related network or coverage conclusions as unsupported by claims data.

Revenue concentration is high: the precomputed top 3 Medicare codes account for 87.9% of this provider’s total Medicare revenue, indicating that a small set of services drives the overwhelming majority of billing. That concentration suggests a focused service mix where most value is tied to a few visit types rather than a broad array of procedures.

Service-line profile points to outpatient chronic and facility-based geriatric care: the largest revenue contributor is 99214 (55.7% of Medicare revenue), an established-patient office/outpatient E/M visit, supplemented by 99484 (24.9%), a behavioral health care management code, and 99309 (7.4%), a subsequent nursing facility visit. This mix implies the provider spends substantial time on established outpatient management and behavioral health coordination for older adults, with additional activity in nursing facility follow-ups.

Competitive standing is uneven across codes: for 99214 the provider ranks #1267 of 479517 nationally and is described as an "extreme outlier, far above typical national volume for this code," indicating a nationally exceptional volume in established outpatient E/M visits. Similarly, for 99484 the provider ranks #9 of 845 and is an "extreme outlier, far above typical national volume for this code," signaling a top-tier national presence in behavioral health care management. In contrast, 99309 ranks at the 61st percentile and is characterized as typical, so the provider is not equally dominant across facility-based visits.

Care intensity mix and visit complexity: the presence of high-volume 99214 and lower-volume 99213/99215 suggests most outpatient encounters center on moderate-level medical decision making rather than predominantly low- or high-complexity visits. The mix with 99484 (behavioral health care management) indicates an operational emphasis on longitudinal coordination and monthly behavioral health follow-up in addition to problem-focused E/M visits.

Tenure and stability: the provider’s NPI was enumerated on 2020-02-05 (approximately 6 years ago), so this billing footprint reflects roughly half a decade of potential Medicare participation; that tenure supports interpreting the high-volume code ranks as sustained practice patterns rather than a very recent anomaly.

Telehealth and facility-fee activity are present but minor: Q3014 (telehealth originating site facility fee) appears in the top-10 codes but represents only 0.9% of Medicare revenue, indicating some use of telehealth sites without it being a primary revenue driver. Nursing facility codes 99305, 99308 and 99309 collectively represent a modest share of revenue, reinforcing that nursing-home work is a meaningful but secondary part of the practice.

Implications for payers and network planning: given the provider’s concentrated Medicare revenue and national outlier status on two front-line codes, payers should treat BARBARA SPEAR as a high-volume Medicare outpatient and behavioral-health management clinician when assessing network capacity or care-management partnerships in Windsor, VT. The lack of Medicaid claims means state Medicaid panels or risk-adjustment efforts cannot rely on direct billing history for this clinician.

Medicare: Complete Services Breakdown

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

9 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…	2,020	$80	$161.5K
99484	Clinical staff members spend at least 20 minutes each month coordinating and managing a patient’s behavioral health services under the direction of a physician or other qualified health care…	2,580	$30	$72.2K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	310	$70	$21.4K
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…	240	$60	$13.8K
99204	The provider sees a new 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 provider…	110	$110	$11.8K
99305	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…	30	$90	$2.9K
Q3014	Telehealth originating site facility fee	120	$20	$2.6K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	40	$50	$2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	20	$110	$1.9K

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 9 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Vermont Distribution

Barbara Spear — 2 of 9 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

9 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99484	1	10	1,620	$30	$46.7K
99309	13	60	140	$70	$12.6K
99214	1	960	90	$70	$10.6K
99215	330	410	40	$110	$7.2K
99308	36	50	80	$50	$6.9K
99213	145	910	80	$50	$6.7K
99204	19	330	30	$100	$4.1K
99305	11	30	30	$90	$3.2K
Q3014	1	10	120	$20	$2.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Medoptions Of New Hampshire LLC	NH	Psychiatry Physician	$0	$470K
Carey Reed	NM	Psychiatric/Mental Health Clinical Nurse Specialist	$341.4K	$0
Lisa Cooper	NH	Family Nurse Practitioner	$273.9K	$0
Medoptions Of Vermont LLC	VT	Psychiatry Physician	$0	$266.4K
Kerry O'hara	NH	Adult Health Nurse Practitioner	$193.7K	$0
Vidhu Menon	NH	Nurse Practitioner	$193.5K	$0
Sabrina Wilkerson	KY	Family Nurse Practitioner	$192.1K	$0
Michelle Segerman	NY	Family Nurse Practitioner	$168.4K	$0
Joshua Gonsher	MD	Clinical Psychologist	$109K	$0
Kathy Boyd	NH	Psychiatric/Mental Health Nurse Practitioner	$96.9K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Connecticut Valley Addiction Recovery, Inc	VT	Addiction Medicine (Internal Medicine) Physician	$0	$1.3M
Connecticut Valley Recovery Services, Inc.	VT	Addiction Medicine (Internal Medicine) Physician	$0	$999.1K
Windsor Hospital Corporation	VT	Internal Medicine Physician	$0	$524.3K
Town Of Windsor	VT	Land Ambulance	$251.6K	$260K
Lauren Pallet	VT	Optometrist	$0	$166.4K
Maxi Green Inc	VT	Community/Retail Pharmacy	$145.7K	$0
Sarah Zwikelmaier	VT	Mental Health Counselor	$0	$86.5K
William Diez	VT	Occupational Therapist	$70.1K	$0
Alden Hall	VT	Hospitalist Physician	$60.8K	$0
Windsor Hospital Corporation	VT	Critical Access Hospital	$0	$56.5K

Barbara Spear — Billing Profile & Reimbursement Data

Sign up for Barbara Spear — Billing Profile & Reimbursement Data policy alerts

Barbara Spear — Billing Profile & Reimbursement Data

Sign up for Barbara Spear — Billing Profile & Reimbursement Data policy alerts

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