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.

Susan Hooper (NPI 1396993952)

Field	Value
Entity Type	Individual
Organization	Susan Hooper
Address	528 Washington Highway
City	Morrisville
State	VT
ZIP	05661
Taxonomy	Nurse Practitioner
NPI Enumerated	September 8, 2008

Payer Source	Total Paid
Medicare	$31.2K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	540	$60	$30.6K
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…	20	$40	$640

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 2 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Vermont Distribution

Susan Hooper — 1 of 2 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Vermont

Full comparison — all codes billed, vs. state median

2 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	34	960	90	$70	$10.6K
99213	862	910	80	$50	$6.7K

Nearby Providers

Other providers in the same ZIP code as Susan Hooper, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lamoille County Health Mental Health Services	VT	Community/Behavioral Health Agency	$0	$42.7M
Green Mountain Support Services Inc.	VT	Case Manager/Care Coordinator	$0	$25.9M
Lamoille County Mental Health Services	VT	Community/Behavioral Health Agency	$0	$22.2M
Lamoille Health Partners, Inc	VT	Cognitive & Behavioral Psychologist	$0	$10.5M
Lamoille Health Partners, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$5.4M
Lamoille Family Center Inc	VT	Public Health or Welfare Agency	$0	$5.2M
Lamoille Health Partners, Inc	VT	Pediatrics Physician	$0	$4.6M
Lamoille Health Partners, Inc	VT	Dentist	$0	$1.7M
Maple Leaf Family Dentistry	VT	General Practice Dentistry	$0	$1.2M
Tamarack Family Medicine	VT	Clinic/Center	$0	$1.1M

Susan Hooper — Billing Profile & Reimbursement Data

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Susan Hooper — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References