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.

Porter Hospital, Inc (NPI 1134457013)

Porter Hospital, Inc is a family medicine physician provider located in Middlebury, Vermont. This profile covers 0 Medicare and 87 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Porter Hospital, Inc
Address	82 Catamount Park
City	Middlebury
State	VT
ZIP	05753
Taxonomy	Family Medicine Physician
NPI Enumerated	December 3, 2009

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

87 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…	23,670	$20	$544.3K
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…	25,120	$10	$351.7K
99391	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…	1,700	$70	$117.4K
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.	2,480	$20	$47.1K
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…	2,580	$20	$41.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	9,660	$1	$38.6K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	3,390	$10	$37.3K
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…	900	$20	$13.5K
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.	1,200	$10	$12K
99203	The provider sees a new 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 provider…	560	$20	$11.7K

Showing 1–10 of 87

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

Porter Hospital, Inc — 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. Vermont median

87 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	13	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.	14	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…	11	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…	393	670	760	$70	$143.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	17	20	630	$30	$118.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	25	30	190	$50	$104.3K
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…	12	320	760	$20	$88.2K
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.	14	20	710	$40	$85K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	6	10	130	$50	$59.5K
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…	32	50	50	$80	$50K

Showing 1–10 of 87

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Paul Unger	VT	Hematology & Oncology Physician	$744.6K	$0
Gregory Aprilliano	NH	Certified Registered Nurse Anesthetist	$0	$478K
James Fitts	CA	Cardiovascular Disease Physician	$389.7K	$0
Sanjay Bose	KY	Interventional Cardiology Physician	$296.5K	$7.9K
Mattie Towle	OR	Family Medicine Physician	$192.7K	$0
Porter Hospital Inc	VT	Emergency Care Clinic/Center	$0	$163.7K
Matthew Daily	NH	Diagnostic Radiology Physician	$150K	$0
Porter Hospital Inc	VT	Critical Access Hospital	$0	$143.4K
Joseph Winget	VT	Cardiovascular Disease Physician	$140.2K	$0
Russell Meyer	VT	Diagnostic Radiology Physician	$126.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialized Community Care, Inc	VT	Community/Behavioral Health Agency	$0	$60.9M
Counseling Service Of Addison County	VT	Developmental Disabilities Clinic/Center	$0	$59.6M
Counseling Service Of Addison County, Inc	VT	Clinic/Center	$0	$22.1M
Middlebury Pediatric Dentistry, PLLC	VT	Pediatric Dentistry	$0	$2.9M
Rainbow Pediatrics	VT	Pediatric Adolescent Medicine Physician	$0	$1.8M
Middlebury Volunteer Ambulance Association, Inc	VT	Ambulance	$508.9K	$1.3M
Brian Collins	VT	Pediatric Dentistry	$0	$606.8K
Middlebury Family Health	VT	Health Maintenance Organization	$0	$547.3K
Amy Gregory	VT	Ophthalmology Physician	$306.6K	$0
Elizabeth Keathley	VT	Clinical Psychologist	$0	$303.3K

Porter Hospital, Inc — Billing Profile & Reimbursement Data

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Porter Hospital, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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