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.

Spectrum, Inc. (NPI 1164556726)

Field	Value
Entity Type	Organization
Organization	Spectrum, Inc.
Address	84 Pine St Fl 2
City	Burlington
State	VT
ZIP	05401
Taxonomy	Addiction (Substance Use Disorder) Counselor
NPI Enumerated	March 15, 2007

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5146	Foster care, therapeutic, child; per month	2,260	$710	$1.6M
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…	10,200	$80	$775.4K
H0004	Behavioral health counseling and therapy, per 15 minutes	620	$80	$47K
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…	170	$60	$9.7K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	80	$70	$5.4K

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

Spectrum, Inc. — 1 of 5 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

5 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5146	Foster care, therapeutic, child; per month	2	10	740	$620	$573.8K
H0004	Behavioral health counseling and therapy, per 15 minutes	15	20	1,410	$80	$247.4K
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…	23	670	760	$70	$143.9K
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…	101	170	360	$20	$35.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	38	90	60	$50	$9.4K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Howard Center Inc	VT	Developmentally Disabled Services Day Training Agency	$0	$332.2M
Howard Center Inc	VT	Adolescent and Children Mental Health Clinic/Center	$0	$130.1M
Vermont Department Of Mental Health	VT	Adult Mental Health Clinic/Center	$0	$105.1M
Community Health Centers Of Burlington Inc	VT	Federally Qualified Health Center (FQHC)	$0	$39.8M
Howard Center Inc	VT	Methadone Clinic	$517.9K	$35M
Howard Center Inc	VT	State or Local Public Health Clinic/Center	$0	$23.4M
University Of Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$17.6M
Transition Ii	VT	Case Manager/Care Coordinator	$0	$17.3M
The Dental Center At Community Health Center Of Burlington	VT	Dental Clinic/Center	$0	$6.7M
City Of Burlington Vermont	VT	Land Ambulance	$677.2K	$4.3M

Spectrum, Inc. — Billing Profile & Reimbursement Data

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Spectrum, 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

Nearby Providers

Frequently Asked Questions

References