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.

Virginia Giles (NPI 1508370073)

Field	Value
Entity Type	Individual
Organization	Virginia Giles
Address	100 E. State Street
City	Montpelier
State	VT
ZIP	05602
Taxonomy	Mental Health Counselor
NPI Enumerated	November 20, 2017

Payer Source	Total Paid
Medicaid	$118.8K
Medicare	$0

Medicaid: Complete Services Breakdown

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

1 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…	1,500	$80	$118.8K

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

Virginia Giles — 0 of 1 code 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

1 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…	242	670	760	$70	$143.9K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Washington County Mental Health Services, Inc.	VT	Community/Behavioral Health Agency	$0	$99.3M
Washington County Family Center	VT	Developmentally Disabled Services Day Training Agency	$0	$6.7M
Treatment Associates, Inc	VT	Mental Health Counselor	$0	$6.2M
Central Vermont Medical Center Inc	VT	Family Medicine Physician	$0	$4.1M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$202.1K	$2.8M
Benjamin Newman	VT	Clinical Social Worker	$0	$1.5M
Central Vermont Medical Center Inc	VT	Internal Medicine Physician	$0	$907.7K
Keene Medical Products, LLC	VT	Durable Medical Equipment & Medical Supplies	$0	$678.6K
M Gould	VT	Psychologist	$0	$574.9K
City Of Montpelier Ambulance	VT	Land Ambulance	$190.7K	$378.7K

Virginia Giles — Billing Profile & Reimbursement Data

Sign up for Virginia Giles — Billing Profile & Reimbursement Data policy alerts

Virginia Giles — Billing Profile & Reimbursement Data

Sign up for Virginia Giles — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References