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.

David Nelson (NPI 1174663066)

Field	Value
Entity Type	Individual
Organization	David Nelson
Address	111 Colchester Ave
City	Burlington
State	VT
ZIP	05401
Taxonomy	Pediatric Emergency Medicine (Emergency Medicine) Physician
NPI Enumerated	February 8, 2007

Payer Source	Total Paid
Medicaid	$119.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	740	$70	$54.9K
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.	490	$100	$48.1K
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.	140	$120	$16.5K

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

David Nelson — 0 of 3 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

3 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.	19	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.	17	30	1,150	$30	$147K
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.	16	30	190	$50	$104.3K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Champlain Valley Physicians Hospital Medical Center	NY	General Acute Care Hospital	$0	$35.9M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Alice Hyde Medical Center	NY	General Practice Physician	$0	$22.4M
University Of Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$17.6M
Atul Jain	CA	Ophthalmology Physician	$3.5M	$0
Northeastern Vermont Regional Hospital, Inc	VT	Primary Care Clinic/Center	$0	$2.8M
Iain Macewan	CA	Radiation Oncology Physician	$2.2M	$0
Carl Rossi	CA	Radiation Oncology Physician	$1.6M	$0
James Stafford	TX	Radiation Oncology Physician	$1.5M	$0
Steven Davis	CA	Radiation Oncology Physician	$1.4M	$0

Nearby Providers

Other providers in the same ZIP code as David Nelson, 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
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.	VT	Addiction (Substance Use Disorder) Counselor	$0	$2.4M

David Nelson — Billing Profile & Reimbursement Data

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David Nelson — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References