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.

North Country Hospital & Health Center Inc (NPI 1417023904)

Key Findings

Field	Value
Entity Type	Organization
Organization	North Country Hospital & Health Center Inc
Address	186 Medical Village Dr
City	Newport
State	VT
ZIP	05855
Taxonomy	Internal Medicine Physician
NPI Enumerated	November 27, 2006

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

This provider is effectively a Medicaid-focused practice with no Medicare billing on file and $3.2M in lifetime Medicaid revenue, making its operational footprint single‑payer in scope for the available data. The absence of Medicare revenue means competitive and service-line analysis should be read through a Medicaid-only lens rather than balanced payer mix metrics.

Revenue is highly concentrated in a small number of codes: the precomputed top 3 Medicaid codes by revenue account for 89.0% of the provider's total Medicaid revenue, with T1015 ($2.1M, 66.3%), 99214 ($608.4K, 19.0%), and 99213 ($120.1K, 3.8%) driving the bulk of receipts. This concentration indicates that a very large share of the practice’s Medicaid income depends on a narrow set of ambulatory evaluation-and-management and bundled clinic encounter services.

T1015 (Clinic visit/encounter, all-inclusive) is the single largest revenue line by far — 54.4K claims for $2.1M and rank #10 of 70 providers in-state (87th percentile; typical, unremarkable volume). The absolute claim volume and dominant revenue share for T1015 point to a high-throughput clinic model that bills bundled visit encounters rather than relying on higher‑paid solo E/M codes.

99214 and 99213 together further characterize the operation as primary care–centric: 99214 shows 40.6K claims and $608.4K revenue while ranking #8 of 323 in-state (98th percentile; notably above typical), and 99213 contributes 17.2K claims and $120.1K revenue while ranking #26 of 319 (92th percentile; typical, unremarkable). The unusually strong statewide rank for 99214 indicates above‑typical volume for moderate-complexity established‑patient office visits compared with in-state peers.

The provider also shows a measurable presence across post‑acute and inpatient E/M codes, with high relative standing on several of those codes: 99309 ($101.2K, rank #2 of 23, 95th percentile; notably above typical), 99239 ($18.7K, rank #2 of 18, 94th percentile; notably above typical), and 99232 ($30.5K, rank #5 of 22, 81th percentile; typical, unremarkable). These entries suggest the organization delivers care across a continuum that includes nursing facility and hospital follow-up/discharge management in addition to ambulatory visits.

Several ancillary/coordination and telehealth codes are billed at notably high relative rates for the state: G9001 (Coordinated care fee, initial rate) is $34.9K and ranks #1 of 19 providers in-state (100th percentile; notably above typical), and G2025 (RHC/FQHC telehealth distant site) is $39.2K and ranks #2 of 26 (96th percentile; notably above typical). The prominence of G9001 and G2025 is consistent with active care‑coordination and telehealth billing patterns often used by rural or clinic-based organizations.

Competitive standing is mixed: the provider is not a statewide volume leader for the single largest code T1015 (rank #10 of 70, 87th percentile; typical), but it is a clear state outlier on several specific lines including 99214 (98th percentile), 99309 (95th percentile), G2025 (96th percentile), and G9001 (100th percentile; notably above typical for each). In practice this means the entity is a modest-to-strong niche player in nursing facility, care coordination, and telehealth billing while running high absolute clinic encounter volumes.

The provider has longstanding enrollment with an NPI enumerated on 2006-11-27 (~20 years ago), indicating long tenure in the market; combined with the concentrated Medicaid revenue mix and the set of codes billed, the pattern suggests an established, clinic-focused organization with embedded relationships in post‑acute settings and consistent telehealth/coordination activity.

Medicaid: Complete Services Breakdown

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

42 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	54,410	$40	$2.1M
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…	40,560	$20	$608.4K
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…	17,150	$10	$120K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	3,620	$30	$101.2K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	1,450	$40	$50.6K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	2,800	$10	$39.2K
G9001	Coordinated care fee, initial rate	3,490	$10	$34.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2,180	$10	$30.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	1,540	$10	$21.5K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	990	$20	$18.7K

Showing 1–10 of 42

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

North Country Hospital & Health Center Inc — 4 of 25 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

42 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	10	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…	8	320	680	$30	$146.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	5	20	630	$30	$118.5K
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…	26	320	760	$20	$88.2K
99204	The provider sees a new 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 provider…	51	50	50	$80	$50K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	14	110	170	$70	$38.6K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	5	10	640	$20	$37.1K
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…	50	70	70	$50	$36K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	8	10	310	$20	$32.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	33	40	170	$40	$31.6K

Showing 1–10 of 42

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Country Hospital & Health Center Inc	VT	Critical Access Hospital	$0	$1.5M
Jonathan Breslau	MN	Diagnostic Radiology Physician	$1.3M	$0
North Country Hospital & Health Center Inc	VT	Rural Health Clinic/Center	$0	$1M
Neil Anand	MN	Diagnostic Radiology Physician	$529.9K	$58.1K
North Country Hospital & Health Center Inc	VT	Obstetrics & Gynecology Physician	$0	$504K
Nzeadibenma Uzochukwu	IL	Diagnostic Radiology Physician	$84K	$360.8K
Jill Wruble	MN	Diagnostic Radiology Physician	$387K	$0
Alice Drown	VT	Mental Health Counselor	$0	$350K
Richard Wilson	MN	Diagnostic Radiology Physician	$304.5K	$0
Syed Anwarulislam	NJ	Diagnostic Radiology Physician	$299.6K	$0

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 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
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$1.7M

North Country Hospital & Health Center 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

Related Providers

Nearby Providers

Frequently Asked Questions

References