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.

Brookside Pediatrics & Adolescent Medicine PLLC (NPI 1568578656)

Brookside Pediatrics & Adolescent Medicine PLLC is a pediatrics physician provider located in Bennington, Vermont. This profile covers 0 Medicare and 44 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Brookside Pediatrics & Adolescent Medicine PLLC
Address	194 North Street
City	Bennington
State	VT
ZIP	05201
Taxonomy	Pediatrics Physician
NPI Enumerated	August 22, 2006

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

44 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…	4,800	$100	$465.6K
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…	4,790	$70	$321.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	750	$100	$71.5K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	2,290	$30	$66.5K
G9001	Coordinated care fee, initial rate	1,220	$40	$47.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	470	$90	$44.1K
96110	The provider screens the patient for a developmental disorder using a standardized instrument (such as a recognized form) focused on areas such as developmental milestones and age–appropriate…	3,840	$10	$26.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	610	$40	$25K
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	510	$40	$18.2K
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…	190	$90	$16.3K

Showing 1–10 of 44

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

Brookside Pediatrics & Adolescent Medicine PLLC — 3 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

44 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…	56	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…	63	320	760	$20	$88.2K
97803	The provider reassesses the dietary needs of a patient and uses specific diet therapy to treat medical conditions and related symptoms by interacting individually with the patient. This code…	12	10	450	$50	$40.8K
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…	62	110	170	$70	$38.6K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	15	40	890	$10	$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…	36	40	170	$40	$31.6K
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…	25	40	280	$20	$19.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	7	20	170	$10	$17.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20	40	290	$20	$16K
G9001	Coordinated care fee, initial rate	5	20	230	$20	$15.6K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Counseling Service Of Bennington County, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$72.5M
Vermont Permanency Initiative, Inc.	VT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$27.9M
Savida Health, PC	VT	Addiction Medicine (Internal Medicine) Physician	$0	$12M
Sunrise Family Resource Center	VT	Social Worker	$0	$7M
Seall Inc	VT	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$6.6M
United Counseling Service Of Bennington County, Inc.	VT	Clinic/Center	$0	$6M
Southwestern Vermont Medical Center Inc.	VT	General Acute Care Hospital	$0	$5.1M
Town Of Bennington Rescue Squad, Inc.	VT	Land Ambulance	$683.4K	$2.7M
Southwestern Vermont Medical Center Inc.	VT	Internal Medicine Physician	$0	$2.9M
Oral And Facial Surgery Associates,plc	VT	Oral and Maxillofacial Surgery (Dentist)	$0	$1.8M

Brookside Pediatrics & Adolescent Medicine PLLC — Billing Profile & Reimbursement Data

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Brookside Pediatrics & Adolescent Medicine PLLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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