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.

Kathy-jo Merlau (NPI 1487012340)

Field	Value
Entity Type	Individual
Organization	Kathy-jo Merlau
Address	390 River St
City	Springfield
State	VT
ZIP	05156
Taxonomy	Mental Health Counselor
NPI Enumerated	February 8, 2016

Payer Source	Total Paid
Medicaid	$512K
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	6,470	$80	$510.8K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	$80	$1.2K

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

Kathy-jo Merlau — 0 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. Vermont median

2 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	54	670	760	$70	$143.9K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	74	90	60	$50	$9.4K

Nearby Providers

Other providers in the same ZIP code as Kathy-jo Merlau, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$13.3M
Springfield Hospital	VT	Critical Access Hospital Clinic/Center	$0	$960.1K
Crissy Webster	VT	Mental Health Counselor	$0	$850.4K
Town Of Springfield	VT	Ambulance	$249.4K	$482K
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$683.8K
Twin State Psychological Services	VT	Psychologist	$0	$519.6K
Springfield Medical Care Systems Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$365.8K
Crissy Webster Counseling Services LLC	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$242.6K
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$204.8K
Vincent Buckholz	VT	Clinical Social Worker	$0	$202.6K

Kathy-jo Merlau — Billing Profile & Reimbursement Data

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Kathy-jo Merlau — 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