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.

Gifford Health Care, Inc (NPI 1184054009)

Field	Value
Entity Type	Organization
Organization	Gifford Health Care, Inc
Address	2418 Airport Rd Ste 1
City	Barre
State	VT
ZIP	05641
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 13, 2013

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

10 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	12,790	$160	$2M
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…	3,940	$1	$15.7K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	580	$10	$7.5K
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…	4,680	$1	$4.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	40	$10	$200
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	100	$0	$0
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	40	$0	$0
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	60	$0	$0
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	10	$0	$0
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	120	$0	$0

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

Gifford Health Care, Inc — 0 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

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	31	70	11,650	$150	$3.3M
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…	71	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…	64	320	760	$20	$88.2K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	30	50	1,020	$20	$87.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	68	90	330	$10	$10K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	25	30	90	$30	$7.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	58	110	150	$10	$4.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	62	80	190	$1	$3.7K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	40	60	420	$1	$1.8K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	71	90	320	$1	$690

Related Providers

Other providers that share a Tax Identification Number (TIN) with Gifford Health Care, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$8.4M
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Gifford Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$935.6K
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$820.3K
Suzanne Carlisle Stebenne	VT	Family Nurse Practitioner	$8.8K	$717.9K
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$344.4K
Jessica Heney	VT	Family Medicine Physician	$0	$273.6K
Gifford Health Care, Inc	VT	General Practice Physician	$0	$256.1K
Paula Despault	VT	Mental Health Counselor	$0	$151.9K
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$111.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Mental Health Services, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$145M
Clearchoicemd, PLLC	VT	Urgent Care Clinic/Center	$0	$10.8M
Pride Support Services Inc	VT	Case Management Agency	$0	$4.4M
Town Of Barre	VT	Land Ambulance	$631.7K	$1.6M
Central Vermont Dental Center	VT	Dentist	$0	$2.2M
City Of Barre	VT	Land Ambulance	$202.5K	$1.1M
Jennie Holden	VT	Clinical Psychologist	$0	$1.1M
Elevate Youth Services Incorporated	VT	Case Management Agency	$0	$1.1M
Jennie Holden Plc	VT	Clinical Psychologist	$0	$1M
Fischer, Ziegler And Lundberg Orthodontics	VT	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$895.5K

Gifford Health Care, Inc — Billing Profile & Reimbursement Data

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Gifford Health Care, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References