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.

Northern Counties Health Care, Inc. (NPI 1194842450)

Key Findings

Field	Value
Entity Type	Organization
Organization	Northern Counties Health Care, Inc.
Address	4 Slapp Hill Road
City	Hardwick
State	VT
ZIP	05843
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	March 23, 2007

Payer Source	Total Paid
Medicaid	$4.4M
Medicare	$0

NORTHERN COUNTIES HEALTH CARE, INC. is a Federally Qualified Health Center enumerated NPI on 2007-03-23 (~19 years ago) and, in the available files, operates as an effectively single‑payer Medicaid provider: Total Medicaid revenue is $4.4M and there is no Medicare billing on file. This tenure and taxonomy align with a long-standing community health center model focused on Medicaid populations in Hardwick, VT.

Revenue is extremely concentrated in a single encounter code: the top three Medicaid codes account for 99.8% of the provider's Medicaid revenue, led by T1015 at $4.3M (97.4% of Medicaid revenue). G0467 contributes $99.5K (2.2%) and 90471 contributes $7K (0.2%), indicating nearly all Medicaid dollars flow through a small set of encounter/bundle codes.

The code mix and dollar concentration point to an FQHC per‑encounter, all‑inclusive payment model as the primary business line: T1015 is the dominant line item (clinic visit/encounter, all‑inclusive) and G0467 (FQHC visit for established patients) is the secondary driver. Ancillary services such as immunizations (90471 and vaccine codes) and phlebotomy (36415) appear frequently in claim counts but represent a very small share of Medicaid revenue, consistent with visit‑based bundled reimbursement.

Competitive standing for T1015 is solid but not top of market: T1015 ranks #17 of 70 providers in‑state at the 77th percentile, described in the data as "typical, unremarkable volume for this code," which indicates above‑median utilization within Vermont but not market dominance. G0467 ranks #9 of 49 (83th percentile) and 90471 ranks #14 of 88 (85th percentile), so the provider shows relatively stronger standing for the specific FQHC visit code and for vaccine administration frequency even though those codes contribute far less revenue than T1015.

There is a notable discordance between claim volume and Medicaid revenue for standard office E/M codes: 99214 and 99213 show very high claim counts (11.3K and 9.6K claims, respectively) but are reported with $0 avg paid/claim and $0 revenue in the Medicaid file. This pattern suggests those E/M services may be documented at the claim level while reimbursement is captured through bundled encounter payments like T1015 or through other payment arrangements not reflected as separate Medicaid line‑item revenue in this dataset.

Clinical breadth is visible but low‑revenue: the record shows routine primary care support services such as vaccines (90688, 90656, 90686, 91320), point‑of‑care and pandemic testing codes (87428, 87880), basic lab draws (36415), and drug/toxicology screening (80305), but together these codes account for a de minimis share of Medicaid dollars (individual revenues range from $528 down to $33). Many of these codes rank modestly to low statewide (for example 80305 ranks #27 of 29, 7th percentile; G2025 telehealth ranks #23 of 26, 12th percentile), indicating operational variety without meaningful separate Medicaid revenue streams.

Telehealth and rural clinic distant‑site payments are present but immaterial to revenue: G2025 appears with 27 claims and $216 revenue (0.0% of Medicaid revenue) and ranks #23 of 26 (12th percentile), so remote‑site telehealth reimbursement does not currently contribute meaningfully to the provider's Medicaid financial profile. Overall, the dataset describes a classic FQHC that captures most Medicaid reimbursement through bundled, per‑encounter payments rather than a diverse set of high‑revenue fee‑for‑service lines.

Medicaid: Complete Services Breakdown

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

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	28,240	$150	$4.3M
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…	3,830	$30	$99.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,350	$1	$7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,080	$1	$2.2K
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…	830	$1	$1.7K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	60	$20	$1.4K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	70	$20	$1.1K
91320	This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL.	10	$40	$530
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	50	$10	$490
90480	The provider administers the first or only component of a SARS–CoV–2 (COVID–19) vaccine by intramuscular injection to reduce the patient's risk of contracting COVID–19.	80	$1	$310

Showing 1–10 of 24

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

Northern Counties Health Care, Inc. — 0 of 16 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	17	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…	23	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…	44	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…	9	50	1,020	$20	$87.6K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	6	10	60	$40	$45.1K
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…	27	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…	119	170	360	$20	$35.9K
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…	67	110	260	$20	$19.5K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	27	30	720	$10	$14.5K
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…	17	20	450	$10	$12.7K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kathleen Landry	VT	Mental Health Counselor	$0	$863.7K
Tracy Ulrich	VT	Mental Health Counselor	$0	$687.6K
Randolph Bulpin	VT	Mental Health Counselor	$0	$652K
Larry Karp	VT	Clinical Psychologist	$0	$452.3K
Wellspring Multidisciplinary Health And Education Project Inc	VT	Psychologist	$0	$416.4K
Colleen Kutin	VT	Clinical Social Worker	$0	$240K
Hardwick Emergency Rescue Squad, Inc.	VT	Ambulance	$126.9K	$93.1K
Talaia Thomas	VT	Mental Health Counselor	$0	$186.6K
Drex Wright	VT	Mental Health Counselor	$0	$172.3K
Whole Family Wellness, Inc.	VT	Naturopath	$0	$156.9K

Northern Counties Health Care, Inc. — Billing Profile & Reimbursement Data

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Northern Counties Health Care, 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Counties Health Care, Inc.	VT	Dental Clinic/Center	$0	$4.5M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$3.4M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.5M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.1M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.3M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.2M
June Goodband	VT	Mental Health Counselor	$0	$145.5K
Krystal-lynn Baptiste	VT	Mental Health Counselor	$0	$99.3K
Amanda Cushing	VT	Clinical Social Worker	$25K	$54.4K