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 1417287665)

Field	Value
Entity Type	Organization
Organization	Northwestern Medical Center, Inc.
Address	4178 Highbridge Rd
City	Fairfax
State	VT
ZIP	05454
Taxonomy	Clinic/Center
NPI Enumerated	January 12, 2010

Payer Source	Total Paid
Medicaid	$67.9K
Medicare	$0

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	1,760	$20	$40.4K
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…	950	$30	$25.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	280	$10	$1.4K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	150	$1	$300
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	260	$1	$260
3725F	The provider screens a patient with dementia for the presence of depression, which is a mental disorder characterized by sadness, guilt feelings, hopelessness, or irritability.	170	$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

Northwestern Medical Center, Inc. — 0 of 5 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

6 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	149	320	680	$30	$146.1K
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…	107	320	760	$20	$88.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	47	90	330	$10	$10K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	34	60	420	$1	$1.8K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	56	90	320	$1	$690
3725F	The provider screens a patient with dementia for the presence of depression, which is a mental disorder characterized by sadness, guilt feelings, hopelessness, or irritability.	3	10	110	$0	$0

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
Northwestern Medical Center Inc	VT	General Acute Care Hospital	$0	$349.6K
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

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
Fairfax Ems Inc	VT	Land Ambulance	$72.1K	$40.6K
Melissa Laflin	VT	Physical Therapist	$49.7K	$0
Krystal Jenness	VT	Physical Therapist	$41.9K	$0
Trevor Trombley	VT	Physical Therapist	$30.5K	$0
Audrey Vonlepel	VT	Internal Medicine Physician	$28.4K	$0
Joseph Boone	VT	Family Nurse Practitioner	$18.7K	$0

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