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 1285064105)

Field	Value
Entity Type	Organization
Organization	Gifford Health Care, Inc
Address	235 S Main St
City	Rochester
State	VT
ZIP	05767
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	November 13, 2013

Payer Source	Total Paid
Medicaid	$344.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	2,160	$160	$334.3K
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…	300	$20	$6K
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…	2,040	$1	$4.1K
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…	230	$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 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	45	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…	220	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…	104	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…	36	50	1,020	$20	$87.6K

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	$2M
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
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

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

Frequently Asked Questions

References