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NPI 1548210198 · Lebanon, NH · Internal Medicine Physician
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Dartmouth-hitchcock Clinic is a internal medicine physician provider located in Lebanon, New Hampshire. This profile covers 12 Medicare and 315 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Dartmouth-hitchcock Clinic |
| Address | One Medical Center Dr |
| City | Lebanon |
| State | NH |
| ZIP | 03756 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | May 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $31.4M |
| Medicare | $624.4K |
This NPI has been active for ~20 years (NPI enumerated 2006-05-12), indicating a long-tenured practice footprint that supports sustained billing across both Medicare and Medicaid. Tenure aligns with a high-volume operational profile in the claims below rather than a newly established service line.
Medicare revenue is concentrated in endoscopic procedures: 45385 ($206.5K) and 45380 ($152.5K) together with 43239 ($80K) drive the bulk of Medicare billing, and the precomputed top-3 Medicare codes account for 70.3% of this provider's total Medicare revenue. The mix (colonoscopies with polypectomy, colon biopsy, and upper endoscopic biopsy) points to a procedural gastroenterology/endoscopy focus within the Internal Medicine taxonomy for Medicare patients.
Medicaid billing is dominated by evaluation-and-management office visits: 99214 ($9.1M) and 99213 ($3.5M) are the two largest Medicaid revenue drivers, and with 99285 ($1.7M) the precomputed top-3 Medicaid codes account for 55.3% of this provider's total Medicaid revenue. This indicates a Medicaid-facing operation that emphasizes high ambulatory visit volume plus significant emergency-department E/M activity.
Payer mix is heavily skewed toward Medicaid: reported Medicaid revenue is $31.4M compared with Medicare revenue of $624.4K, meaning Medicaid is the primary revenue source on file for this NPI. The dataset therefore reflects a provider whose scale and business risk are largely tied to Medicaid volume and reimbursement patterns.
Competitive standing differs by payer and code set: for Medicare the provider is a national high-volume outlier on key endoscopy codes—45385 ranks #330 of 16310 (98th percentile; notably above typical national volume) and 45380 ranks #264 of 16427 (98th percentile; extreme outlier, far above typical national volume). For Medicaid the provider is a statewide dominant contributor on core codes: 99214 and 99213 both rank #1 in-state (100th percentile; extreme outlier, far above typical state volume), signaling leading market share in those service lines locally.
The provider's Medicare procedural profile versus Medicaid service mix suggests dual operational roles: Medicare billing is concentrated in diagnostic and therapeutic endoscopy (45385, 45380, 43239), while Medicaid billing centers on high-volume ambulatory E/M, imaging, and ancillary services (99214, 99213, 88305, 74177). This pattern is consistent with a practice that performs specialized procedures for Medicare patients while acting as a high-volume ambulatory and acute-care hub for Medicaid beneficiaries.
Several codes are explicit statistical outliers within their peer sets and should be noted for network and utilization planning: 45380 is labeled an "extreme outlier, far above typical national volume" among Medicare peers, and Medicaid codes such as 99214, 99213, 88305, and 74177 are each described as "extreme outlier, far above typical state volume" or rank #1 in-state. Those labels indicate materially higher-than-typical utilization relative to peers rather than marginal differences.
Revenue concentration risk is meaningful for both payers because a small number of codes generate a large share of income: the top-3 Medicare codes account for 70.3% of Medicare revenue and the top-3 Medicaid codes account for 55.3% of Medicaid revenue. Payers and network managers should consider this concentration when assessing referral patterns, capacity for endoscopy and ambulatory visits, and the financial impact of coding or utilization changes on this NPI.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
12 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 480 | $430 | $206.5K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 460 | $330 | $152.5K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 350 | $230 | $80K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 140 | $390 | $52.8K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 80 | $560 | $44.3K |
| 64721 | Neuroplasty or transposition of the median nerve at the carpal tunnel is done to treat a condition called carpal tunnel syndrome (CTS). The carpal tunnel is a narrow tunnel in the wrist through which… | 40 | $630 | $23.2K |
| G0121 | Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk | 50 | $400 | $20.5K |
| 45381 | The provider inserts a flexible endoscope into the anus and navigates the scope through the entire colon. The provider performs one or more injections into the submucosa (the tissue below the mucous… | 50 | $230 | $11.6K |
| 26055 | Trigger finger, or stenosing tenosynovitis, is when a finger remains in a bent position. It is painful to open or close the finger. A swollen tendon or formation of knots or nodules in the tendon may… | 30 | $440 | $10.9K |
| 43251 | An esophagogastroduodenoscopy is a procedure to view the esophagus, stomach, and duodenum by means of flexible endoscope through the mouth. The physician removes one or more lesions using a snare… | 20 | $520 | $8.8K |
Showing 1–10 of 12
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
315 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… | 175,300 | $50 | $9.1M |
| 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… | 97,660 | $40 | $3.5M |
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 21,110 | $80 | $1.7M |
| 88305 | The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally… | 41,670 | $30 | $1.4M |
| 99233 | The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the… | 23,090 | $40 | $877.5K |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 13,780 | $60 | $771.7K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 16,490 | $40 | $692.7K |
| D7210 | Extraction, erupted tooth requiring removal of bone and/or sectioning of tooth, and including elevation; includes related cutting of gingiva and bone, removal of tooth structure, minor smoothing of… | 7,900 | $80 | $616.3K |
| 99392 | 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… | 9,390 | $60 | $591.4K |
| D7240 | N/A | 2,010 | $290 | $581.5K |
Showing 1–10 of 315
How this provider's Medicaid billing volume and revenue compare to other New Hampshire providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. New Hampshire median
315 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 99285 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making. | 5 | 60 | 1,820 | $150 | $756.5K |
| 99284 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making. | 11 | 80 | 2,220 | $120 | $745.6K |
| 99283 | The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making. | 60 | 70 | 2,540 | $110 | $733.8K |
| 74177 | The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs. | 1 | 50 | 1,150 | $230 | $480.4K |
| H0015 | Alcohol and/or drug services; intensive outpatient (treatment program that operates at least 3 hours/day and at least 3 days/week and is based on an individualized treatment plan), including… | 25 | 30 | 500 | $110 | $455.7K |
| J0585 | Injection, onabotulinumtoxina, 1 unit | 3 | 10 | 930 | $390 | $354.9K |
| 90834 | In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere… | 34 | 130 | 520 | $50 | $338.8K |
| 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… | 160 | 190 | 500 | $70 | $286.7K |
| 70450 | The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities. | 1 | 50 | 1,250 | $90 | $224K |
| 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… | 1 | 420 | 480 | $50 | $223.9K |
Showing 1–10 of 315
Other providers in the same ZIP code as Dartmouth-hitchcock Clinic, ranked by combined Medicare and Medicaid revenue.
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