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.

Northeast Vision Center, PC (NPI 1316933583)

Field	Value
Entity Type	Organization
Organization	Northeast Vision Center, PC
Address	5452 Us Route 5
City	Newport
State	VT
ZIP	05855
Taxonomy	Clinic/Center
NPI Enumerated	September 23, 2005

Payer Source	Total Paid
Medicaid	$68.2K
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
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	310	$120	$37.9K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	1,040	$20	$16.6K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	100	$100	$9.6K
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…	110	$40	$4.1K
1036F	N/A	10	$0	$0
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	20	$0	$0
G8428	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	40	$0	$0
G9366	One high-risk medication not ordered	20	$0	$0
G9368	At least two orders for high-risk medications from the same drug class not ordered	20	$0	$0
G9903	Patient screened for tobacco use and identified as a tobacco non-user	10	$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

Northeast Vision Center, PC — 0 of 4 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
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…	248	320	760	$20	$88.2K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	36	50	290	$70	$66.1K
92004	The provider performs a comprehensive level ophthalmological evaluation of a new patient and initiates a diagnostic and treatment program for one or more visits.	23	60	170	$100	$52.9K
92015	The provider determines the process of determining if a patient's vision is less than 20/20 and by what amount so that corrective lenses or contact lenses can be prescribed and produced.	33	70	850	$10	$26.9K
1036F	N/A	12	10	180	$1	$1
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	21	20	190	$0	$0
G8428	Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given	2	10	40	$0	$0
G9366	One high-risk medication not ordered	1	10	20	$0	$0
G9368	At least two orders for high-risk medications from the same drug class not ordered	1	10	20	$0	$0
G9903	Patient screened for tobacco use and identified as a tobacco non-user	11	10	170	$0	$0

Nearby Providers

Other providers in the same ZIP code as Northeast Vision Center, PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Kingdom Human Services Inc Ds Waiver	VT	Developmental Disabilities Clinic/Center	$0	$204.7M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$85.8K	$17.6M
Northeast Kingdom Human Services Inc Sbs	VT	Adolescent and Children Mental Health Clinic/Center	$0	$8.3M
Autism Advocacy And Intervention, LLC	VT	Behavior Analyst	$0	$7.8M
Newport Ambulance Service Inc.	VT	Land Ambulance	$743.2K	$2.9M
North Country Hospital & Health Center Inc	VT	Internal Medicine Physician	$0	$3.2M
North East Kingdom Community Action, Inc.	VT	Public Health or Welfare Agency	$0	$2.8M
Northeast Kingdom Human Services Inc Mh Children	VT	Adolescent and Children Mental Health Clinic/Center	$0	$2.7M
North Country Hospital & Health Center Inc	VT	Pediatrics Physician	$0	$2.2M
James V. Wyllie, Dds P.C.	VT	General Practice Dentistry	$0	$1.8M

Northeast Vision Center, PC — Billing Profile & Reimbursement Data

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Northeast Vision Center, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References