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 New Hampshire for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to New Hampshire 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. New Hampshire (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.

Developmental Services Of Sullivan County, Inc. (NPI 1295957561)

Field	Value
Entity Type	Organization
Organization	Developmental Services Of Sullivan County, Inc.
Address	654 Main Street
City	Claremont
State	NH
ZIP	03743
Taxonomy	Child Intellectual and/or Developmental Disabilities Respite Care
NPI Enumerated	May 3, 2007

Payer Source	Total Paid
Medicaid	$139.4M
Medicare	$0

Key Findings

This entity is effectively a Medicaid-only billing organization: there is no Medicare billing on file and total Medicaid lifetime revenue is $139.4M. The provider’s NPI was enumerated 2007-05-03 (~19 years ago), indicating a long-tenured presence in the market focused on publicly funded programs rather than Medicare fee-for-service streams.

Revenue is highly concentrated in a very small set of waiver and personal-care codes: the precomputed top 3 Medicaid codes by revenue account for 92.9% of this provider's total Medicaid revenue. Those top three are T1020 ($90.2M, 64.7% of Medicaid revenue), T2021 ($21M, 15.0%), and T2025 ($18.4M, 13.2%), which together dominate the organization’s financial footprint and suggest sensitivity to changes in those specific service rates or authorization policies.

The code mix aligns with operations centered on community-based supports for individuals with intellectual and developmental disabilities rather than clinical medical services. T1020 is the largest single driver and is described as personal care services per diem tied to individualized plans of treatment; combined with substantial T2021 day habilitation and T2025 waiver-NOS revenue, this profile is consistent with an organization delivering routine personal care, day habilitation programming, and broad waiver services.

Despite very high revenue concentration, this provider is a modest-to-typical statewide participant on its highest-volume codes rather than an extreme outlier. T1020 ranks #9 of 41 providers in-state (80th percentile; typical, unremarkable volume for this code), T2021 ranks #10 of 39 (76th percentile; typical, unremarkable volume), and T2025 ranks #10 of 14 (31th percentile; typical, unremarkable volume), indicating the provider captures substantial dollars through scale on common services but is not uniquely dominant across all comparable in-state suppliers.

Operational and payer risk is concentrated by service line: with T1020 alone representing $90.2M (64.7% of Medicaid revenue) and the top three codes making up 92.9% of Medicaid revenue, any policy, reimbursement, or eligibility changes affecting personal care or waiver day habilitation services could materially impact the provider’s topline. Diversification across additional service codes appears limited based on the share breakdown.

Smaller but relevant revenue streams supplement the core waiver and personal care mix and point to a broader service suite within the developmental-disabilities continuum. Examples include T2022 case management ($4.2M, 3.0%), T1024 integrated specialty team encounters ($2.1M, 1.5%), and T1005 respite care services ($1.5M, 1.1%); each of these are reported as typical, unremarkable volume relative to in-state peers, suggesting routine use rather than niche specialization.

Competitive positioning should be read as a high-volume operator in a narrow set of Medicaid service lines: rankings in the 76th–80th percentiles for the two largest codes imply meaningful scale within the state market for those services, while lower percentiles on T2025 and other codes show room for either growth or competitive pressures in adjacent waiver service categories.

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
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	288,120	$310	$90.2M
T2021	Day habilitation, waiver; per 15 minutes	151,930	$140	$21M
T2025	Waiver services; not otherwise specified (nos)	11,260	$1,630	$18.4M
T2022	Case management, per month	17,480	$240	$4.2M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	8,440	$250	$2.1M
T2023	Targeted case management; per month	6,780	$240	$1.6M
T1005	Respite care services, up to 15 minutes	18,880	$80	$1.5M
H2015	Comprehensive community support services, per 15 minutes	4,510	$50	$221.1K
H2023	Supported employment, per 15 minutes	7,150	$30	$200.2K
S5165	Home modifications; per service	10	$2,170	$26.1K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other New Hampshire providers billing the same CPT/HCPCS codes.

Claims Volume vs. New Hampshire Distribution

Developmental Services Of Sullivan County, Inc. — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Hampshire

Full comparison — all codes billed, vs. New Hampshire median

10 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1020	Personal care services, per diem, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	9	40	14,020	$330	$32.2M
T2025	Waiver services; not otherwise specified (nos)	10	10	20,960	$1,140	$26.7M
T2021	Day habilitation, waiver; per 15 minutes	10	40	11,650	$170	$12.7M
T2022	Case management, per month	10	20	4,510	$240	$3.5M
T2023	Targeted case management; per month	10	10	10,730	$230	$3.2M
H2023	Supported employment, per 15 minutes	17	30	11,450	$120	$2.3M
T1024	Evaluation and treatment by an integrated, specialty team contracted to provide coordinated care to multiple or severely handicapped children, per encounter	11	20	10,250	$240	$2.2M
T1005	Respite care services, up to 15 minutes	7	10	18,880	$90	$1.6M
H2015	Comprehensive community support services, per 15 minutes	19	30	10,280	$90	$1.5M
S5165	Home modifications; per service	3	10	160	$3,050	$408.6K

Nearby Providers

Other providers in the same ZIP code as Developmental Services Of Sullivan County, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Valley Regional Hospital Inc.	NH	Critical Access Hospital	$0	$10M
Colin B Boswell Dds PC	NH	Pediatric Dentistry	$0	$5.2M
Golden Cross Ambulance Inc	NH	Ambulance	$1.2M	$3.5M
Claremont School District	NH	Local Education Agency (LEA)	$0	$3M
Daniel Peraza	NH	Dermatology Physician	$1.1M	$0
Sullivan County Oral Health Collaborative	NH	Dental Clinic/Center	$0	$892.1K
Valley Regional Hospital, Inc.	NH	Urgent Care Clinic/Center	$0	$875.8K
Jose E Peraza Md PLLC	NH	Dermatology Physician	$0	$870.9K
Valley Regional Hospital, Inc	NH	Family Medicine Physician	$0	$782K
Samuel Giveen	NH	Optometrist	$120.2K	$544.2K

Developmental Services Of Sullivan County, Inc. — Billing Profile & Reimbursement Data

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Developmental Services Of Sullivan County, 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

Nearby Providers

Frequently Asked Questions

References