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.

Northwestern Medical Center Inc (NPI 1386689875)

Field	Value
Entity Type	Organization
Organization	Northwestern Medical Center Inc
Address	133 Fairfield St
City	Saint Albans
State	VT
ZIP	05478
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 18, 2006

Payer Source	Total Paid
Medicaid	$349.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	16,720	$20	$334.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,120	$1	$4.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	70	$50	$3.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	50	$50	$2.8K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	30	$60	$1.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	300	$10	$1.5K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	30	$20	$600
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10	$50	$590
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	40	$10	$490
36592	The provider collects a blood specimen from an established central or peripheral catheter; this procedure is not otherwise specified by any other code.	140	$0	$0

Showing 1–10 of 22

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

Northwestern Medical Center Inc — 0 of 9 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	4	10	16,150	$20	$239.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	25	30	830	$40	$232.2K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	25	30	1,150	$30	$147K
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…	312	320	680	$30	$146.1K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	10	10	1,680	$30	$137K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	18	30	190	$50	$104.3K
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…	278	320	760	$20	$88.2K
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	10	10	240	$60	$81.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6	10	150	$170	$49.6K
99203	The provider sees a new 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 provider…	64	70	70	$50	$36K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northwestern Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwestern Medical Center, Inc.	VT	Pediatrics Physician	$0	$1.4M
Northwestern Medical Center, Inc.	VT	General Acute Care Hospital	$0	$1.1M
Northwestern Medical Center, Inc.	VT	Urgent Care Clinic/Center	$0	$757.2K
Northwestern Medical Center, Inc.	VT	Pediatrics Physician	$0	$596.5K
Michael Hooker	VA	Orthopaedic Surgery Physician	$382.5K	$0
Gregory Brophey	VT	Ophthalmology Physician	$234.2K	$0
Michael Barnum	FL	Orthopaedic Surgery of the Spine Physician	$200.3K	$0
Northwestern Medical Center, Inc.	VT	Family Medicine Physician	$0	$176.8K
Stephanie Neider	VT	Dermatology Physician	$145.1K	$0
Joseph Winget	VT	Cardiovascular Disease Physician	$140.2K	$0

Nearby Providers

Other providers in the same ZIP code as Northwestern Medical Center Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwestern Counseling & Support Services	VT	Community/Behavioral Health Agency	$0	$129.9M
Northwestern Counseling & Support Services Inc	VT	Community/Behavioral Health Agency	$0	$70.4M
Amcare Medical Systems, Inc.	VT	Land Ambulance	$576.2K	$2.2M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$180.2K	$2.5M
Remy Vallee Dmd Inc	VT	Dentist	$0	$1.1M
Calm Reflections Psychotherapy, LLC	VT	Clinical Social Worker	$0	$840.8K
Northern Valley Eyecare, Inc.	VT	Optometrist	$0	$703.1K
Michelle Pelkey	VT	Clinical Social Worker	$0	$550.9K
Gillian Ireland	VT	Mental Health Counselor	$0	$388.4K
Avalon Natural Medicine Of Vermont, PLLC	VT	Naturopath	$0	$373K

Northwestern Medical Center Inc — Billing Profile & Reimbursement Data

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Northwestern Medical Center 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