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.

Northeast Washington County Community Health Inc (NPI 1609083922)

Field	Value
Entity Type	Organization
Organization	Northeast Washington County Community Health Inc
Address	157 Towne Ave
City	Plainfield
State	VT
ZIP	05667
Taxonomy	Dentist
NPI Enumerated	May 17, 2007

Payer Source	Total Paid
Medicaid	$5.8M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused dental practice: it has no Medicare billing on file and reports $5.8M in total Medicaid revenue, with an NPI enumerated 2007-05-17 (~19 years ago), indicating long-tenured participation in the state Medicaid program. The absence of Medicare activity and the size of Medicaid receipts together imply near‑exclusive reliance on Medicaid as the payer source for its billed services.

Revenue is moderately concentrated in a small set of restorative and preventive codes: the precomputed top three Medicaid codes account for 33.3% of the provider's total Medicaid revenue, specifically D2392 ($703.3K, 12.1%), D1110 ($625K, 10.8%), and D7140 ($606.3K, 10.4%). These three codes alone drive roughly one-third of Medicaid receipts, so changes in utilization or reimbursement for these services would meaningfully shift overall revenue.

The code mix and descriptions indicate this operation is a high-volume community dental clinic delivering both preventive and basic restorative/extraction services: leading codes include D1110 (Prophylaxis - adult), D1120 (Prophylaxis–child), D0120 (Periodic oral evaluation), D1206 (Topical Fluoride Treatment), D2392/D2391 (resin-based composites) and D7140 (extractions). That blend of prophylaxis, fluoride, sealants (D1351), routine evaluations and posterior composites suggests the practice treats large numbers of both pediatric and adult Medicaid patients with an emphasis on routine, high-throughput dental care and basic operative dentistry.

Claim-volume indicators reinforce a high-throughput preventive model: the provider reported 19.9K claims for D1206, 18.8K claims for D0120, 12.8K claims for D1110 and 11.1K claims for D1351, which together reflect substantial per‑code utilization and frequent, routine patient contacts. These claim counts, paired with the large aggregate Medicaid revenue, point to a practice workflow optimized for large patient panels and repeat preventive visits rather than low-volume specialty procedures.

Statewide competitive standing is strong across multiple core codes: D1110 ranks #3 of 150 providers in-state (99th percentile, labeled an "extreme outlier"), D0120 ranks #4 of 156 (98th percentile, "extreme outlier"), and D1206 ranks #3 of 115 (98th percentile, "extreme outlier"). Restorative and extraction codes are similarly high relative to peers—D2392 ranks #3 of 59 (97th percentile, "notably above typical") and D7140 ranks #3 of 45 (95th percentile, "notably above typical")—indicating the provider is a major statewide participant for both preventive and common operative services.

The provider also occupies top positions for several less-common codes, suggesting capability in some specialized or billable ancillary services: it ranks #1 of 4 for D9243 ($142.3K, 2.4%), #1 of 5 for D9310 ($136.6K, 2.4%), and #1 of 4 for D9239 ($132.8K, 2.3%). While each of these single-code revenues represents a modest share of total Medicaid revenue, the #1 ranks indicate the practice is one of only a few in-state providers delivering these particular services at scale.

Across the Medicaid portfolio the provider shows broad above-typical volumes: numerous codes beyond the top three—D2391, D1120, D1351, D0274, D0140 and others—appear in high state percentiles (many ≥94th–98th), signaling comprehensive service delivery rather than reliance on a single procedure line. This distribution implies the practice maintains supply, staffing and process capability to deliver a wide range of preventive, diagnostic and basic operative dental services to the Medicaid population.

Operationally, the combination of a single‑payer Medicaid revenue base ($5.8M) and a revenue concentration where the top three codes represent 33.3% of Medicaid receipts highlights policy and reimbursement sensitivity: substantive changes to Medicaid coverage or payment for high-volume codes like D2392, D1110 or D7140 could have outsized impact on overall clinic revenue. For payer or network analysts, this profile flags the provider as a high-volume Medicaid partner whose financial and access contributions are closely tied to a handful of routine dental services.

Medicaid: Complete Services Breakdown

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

33 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
D2392	Post 2 surface resin‑based composite	5,580	$130	$703.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	12,760	$50	$625K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	6,450	$90	$606.3K
D0120	Periodic oral evaluation - established patient	18,830	$30	$489.7K
D7240	N/A	1,610	$270	$439.3K
D1120	Prophylaxis–child	11,140	$40	$412.2K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	19,930	$20	$398.5K
D2391	Resin‑based composite – one surface, posterior	3,380	$90	$290.3K
D1351	Sealant - per tooth	11,320	$30	$283.1K
D0274	N/A	6,760	$30	$209.6K

Showing 1–10 of 33

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

Northeast Washington County Community Health Inc — 13 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

33 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
D7240	N/A	2	10	220	$250	$190.7K
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…	12	20	770	$140	$185K
D9222	N/A	5	10	880	$150	$158.1K
D2392	Post 2 surface resin‑based composite	3	60	610	$130	$155.6K
D9223	N/A	5	10	780	$130	$120.9K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	3	50	400	$80	$101.1K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	3	150	540	$50	$73.5K
D1351	Sealant - per tooth	3	40	480	$20	$63.9K
D2391	Resin‑based composite – one surface, posterior	3	50	310	$90	$62.9K
D9230	N/A	11	20	500	$50	$59.7K

Showing 1–10 of 33

Nearby Providers

Other providers in the same ZIP code as Northeast Washington County Community Health Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Washington County Community Health, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$5.3M
Tina Desmarais	VT	Mental Health Counselor	$0	$514.3K
Northeast Washington County Community Health Inc	VT	Multi-Specialty Clinic/Center	$0	$53.3K
Elisha Mclam	VT	Family Medicine Physician	$13.4K	$0
Barry Ryan	VT	Family Medicine Physician	$10.7K	$0
Margery Bower	VT	Medical Physician Assistant	$9.9K	$0
Emma Kopecky	VT	Adult Health Nurse Practitioner	$7.1K	$0
John Matthew	VT	Internal Medicine Physician	$7.1K	$0
Jessica Fisch	VT	Medical Physician Assistant	$4K	$0
Sara Bylow	VT	Medical Physician Assistant	$3.2K	$0

Northeast Washington County Community Health Inc — Billing Profile & Reimbursement Data

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Northeast Washington County Community Health Inc — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References