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.

Carlos G Otis Health Care Center Inc (NPI 1124049960)

Key Findings

Field	Value
Entity Type	Organization
Organization	Carlos G Otis Health Care Center Inc
Address	185 Grafton Rd.
City	Townshend
State	VT
ZIP	05353
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	July 21, 2006
NPI Deactivated	June 2, 2020

Payer Source	Total Paid
Medicaid	$6M
Medicare	$0

This provider is effectively single-payer: there is no Medicare billing on file and all reported activity is Medicaid-only, with lifetime Medicaid revenue of $6M. The NPI was enumerated 2006-07-21 (~20 years ago), indicating a long-standing presence in the community rather than a recently established clinic.

Revenue is extremely concentrated: the precomputed top-3 Medicaid codes account for 98.1% of this provider’s total Medicaid revenue, and a single code — T1015 — drives the vast majority of receipts at $5.5M (92.2% of Medicaid revenue). That concentration means financial performance is tightly tied to how T1015 encounters are billed and reimbursed.

T1015 (T1015 – Clinic visit/encounter, all-inclusive) dominates the clinical footprint with 36.4K claims and an average paid/claim of $151, producing $5.5M in revenue. This mix is consistent with an RHC-style operation where bundled, all-inclusive clinic visit payments form the core business model, and it dwarfs standalone E/M billing dollars.

The provider still reports substantial volume in standard E/M codes: 99214 has 12.8K claims at $17 avg paid/claim generating $217K (ranks #16 of 323, 95th percentile; typical, unremarkable volume for this code) and 99213 has 17K claims at $8 avg paid/claim generating $136.1K (ranks #27 of 319, 92th percentile; typical, unremarkable volume for this code). These high percentile rankings for 99214 and 99213 indicate above-average E/M encounter counts relative to in-state peers even though those codes contribute only a few percent of total revenue.

Competitive standing for the top revenue driver is moderate: T1015 ranks #14 of 70 (81th percentile; typical, unremarkable volume for this code) in-state, so while T1015 produces most revenue for this clinic, the provider is not a dominant outlier among Vermont peers for that specific code. By contrast, telehealth use measured by G2025 (856 claims, $18 avg paid/claim, $15.4K revenue) ranks #4 of 26 (88th percentile; typical, unremarkable volume for this code), indicating relatively strong telehealth adoption among RHCs in the state.

The clinical mix shows breadth beyond primary clinic visits: mental health services (90834: 2.2K claims, $14 avg, $30.3K revenue; 90792: 155 claims, $18 avg, $2.8K revenue) and preventive services/vaccinations (90471: 3.6K claims, $3 avg, $10.8K revenue; 90686 and 90656 also present) are billed, suggesting integrated behavioral health and immunization activity alongside core RHC services. Each of these codes is characterized in the file as having "typical, unremarkable volume for this code," so they appear to be routine parts of the clinic’s service mix rather than unusual service lines.

Emergency and urgent-care–level encounters appear at low volumes: 99283 (456 claims, $48 avg, $21.9K revenue) ranks #19 of 28 (33th percentile; typical, unremarkable volume for this code) and 99284 (61 claims, $89 avg, $5.4K revenue) ranks #24 of 31 (23th percentile; typical, unremarkable volume for this code). These low percentiles and small revenue shares suggest occasional urgent/ED-level visits but not a major emergency-service business line for the provider.

The reimbursement profile highlights how payment structure shapes revenue: T1015’s $151 avg paid/claim generates the bulk of revenue despite other high-volume codes like 99213 and 99214 having much lower avg paid/claim ($8 and $17 respectively). That contrast underscores the financial importance of bundled clinic encounter payments for this RHC and implies sensitivity to any policy or rate changes affecting T1015 reimbursement.

Medicaid: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	36,410	$150	$5.5M
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…	12,770	$20	$217K
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…	17,020	$10	$136.1K
90834	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…	2,170	$10	$30.3K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	460	$50	$21.9K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	860	$20	$15.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	3,610	$1	$10.8K
T1023	Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter	310	$30	$10.3K
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…	280	$30	$8.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	60	$90	$5.4K

Showing 1–10 of 32

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

Carlos G Otis Health Care Center Inc — 1 of 20 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

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	14	70	11,650	$150	$3.3M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	24	30	830	$40	$232.2K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	19	30	1,150	$30	$147K
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…	16	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…	27	320	760	$20	$88.2K
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…	44	110	170	$70	$38.6K
90834	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…	29	170	360	$20	$35.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	15	20	520	$20	$22K
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…	21	40	280	$20	$19.5K
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…	104	110	260	$20	$19.5K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jill Wruble	MN	Diagnostic Radiology Physician	$387K	$0
Dietrich Schultze	MA	Vascular & Interventional Radiology Physician	$322.9K	$0
Richard Wilson	MN	Diagnostic Radiology Physician	$304.5K	$0
Talitha Travis	MN	Diagnostic Radiology Physician	$226.8K	$0
Kimberly Jordan	MN	Diagnostic Radiology Physician	$215.2K	$0
Stephen Oljeski	PA	Diagnostic Radiology Physician	$156.1K	$40.4K
David Moon	MN	Diagnostic Radiology Physician	$190.3K	$0
Michael Allen	MN	Diagnostic Radiology Physician	$178.8K	$990
Craig Goldberg	MA	Family Medicine Physician	$68.1K	$104.1K
Demetrice Davis	MN	Diagnostic Radiology Physician	$82.5K	$88.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alexandra Van Dyck	VT	Internal Medicine Physician	$173.2K	$0
Jesper Brickley	VT	Family Medicine Physician	$95.8K	$0
Judith Tietz	VT	Psychiatry Physician	$32.3K	$52.7K

Carlos G Otis Health Care Center Inc — Billing Profile & Reimbursement Data

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Carlos G Otis Health Care Center 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