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.

Lamoille Health Partners, Inc (NPI 1639127681)

Field	Value
Entity Type	Organization
Organization	Lamoille Health Partners, Inc
Address	609 Washington Hwy
City	Morrisville
State	VT
ZIP	05661
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 4, 2006

Payer Source	Total Paid
Medicaid	$5.4M
Medicare	$0

Key Findings

LAMOILLE HEALTH PARTNERS, INC operates as a Federally Qualified Health Center (FQHC) and its Medicaid billing profile is dominated by bundled clinic-visit payments: T1015 accounts for 29.7K claims at $172 avg paid/claim generating $5.1M in revenue, which is 95.3% of this provider's total Medicaid revenue. This concentration indicates the organization primarily bills per-encounter, all-inclusive clinic visit payments consistent with FQHC outpatient primary care delivery.

The provider’s Medicaid revenue is $5.4M and there is no Medicare billing on file, so this entity is effectively single-payer in the available dataset with Medicaid as the primary revenue source and no measurable Medicare contribution. This payer mix implies heavy operational dependence on Medicaid reimbursement policies and patient volume.

Revenue concentration is extreme: the precomputed top 3 codes account for 99.3% of this provider's total Medicaid revenue, with T1015 (95.3%), G0467 (3.3%), and 90471 (0.6%) together dominating receipts. Such concentration signals that financial performance will be highly sensitive to payment or utilization changes for a very small set of FQHC and visit-related codes.

Competitive standing within the state is modest-to-strong but not dominant: T1015 ranks #16 of 70 providers (78th percentile), described as typical/unremarkable volume for that code, while G0467 ranks #6 of 49 providers (90th percentile) which places the site toward the top for established FQHC visit volume. In plain terms, the center is a meaningful regional FQHC participant (especially on the G0467 metric) but not the single-market leader on the primary revenue-driving code.

Service-line mix beyond the core clinic bundle shows preventive and point-of-care services consistent with a community health center: vaccines and immunizations appear across several codes (90471: 2.2K claims, $15 avg, $32.7K revenue; 90688: 207 claims, $10 avg, $2.1K revenue; 90472: 74 claims, $18 avg, $1.3K revenue) and on-site lab/point-of-care testing is billed at small volumes (80305, 87880, 87635 and others). These ancillary services contribute only minor revenue relative to T1015 but confirm typical primary care, vaccination, and basic lab capabilities on site.

Reported claims-data anomalies are visible in the Medicaid file: several high-count E/M and ancillary codes show non-zero claim counts but $0 avg paid/claim and $0 revenue (for example 99213: 18.7K claims, $0 avg paid/claim, $0 revenue; 99214: 9.4K claims, $0 avg paid/claim, $0 revenue; 96127: 1.6K claims, $0 avg paid/claim, $0 revenue). This pattern is data-grounded in the submission and suggests either bundled reporting under T1015 or dataset-level payment reporting conventions rather than a lack of clinical activity for those CPTs.

On vaccine and public-health responsiveness, the practice ranks relatively high for certain immunization codes despite their small revenue share: 90688 ranks #3 of 17 providers (88th percentile) and 90471 ranks #17 of 88 providers (82nd percentile), indicating above-typical throughput for seasonal or routine vaccination services compared with state peers. While these services are not major revenue drivers, they appear to be an operational emphasis within the clinic mix.

Tenure and institutional stability are supported by the NPI enumeration date: the provider was registered on 2006-05-04 (~20 years ago), indicating long-standing presence in the market. Combined with the concentrated FQHC billing pattern, this suggests an established community health operation whose financial profile is tightly linked to Medicaid encounter payments.

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	29,730	$170	$5.1M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	7,170	$30	$179.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,180	$20	$32.7K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	840	$10	$10.1K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	370	$20	$5.9K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	120	$50	$5.7K
G9001	Coordinated care fee, initial rate	140	$40	$5.5K
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.	170	$20	$2.7K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	210	$10	$2.1K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	70	$20	$1.3K

Showing 1–10 of 29

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

Lamoille Health Partners, Inc — 0 of 19 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	16	70	11,650	$150	$3.3M
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…	31	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…	20	320	760	$20	$88.2K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	6	50	1,020	$20	$87.6K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	55	60	390	$40	$56.1K
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.	11	20	170	$10	$17.3K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	12	20	180	$40	$15.6K
G9001	Coordinated care fee, initial rate	13	20	230	$20	$15.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	13	30	720	$10	$14.5K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	21	30	160	$10	$10K

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with Lamoille Health Partners, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lamoille Health Partners, Inc	VT	Cognitive & Behavioral Psychologist	$0	$10.5M
Lamoille Health Partners, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$4.9M
Lamoille Health Partners, Inc	VT	Pediatrics Physician	$0	$4.6M
Lamoille Health Partners, Inc	VT	Dentist	$0	$1.7M
Heather Jones	VT	Mental Health Counselor	$0	$231.3K
Katherine Wilde	VT	Adult Psychiatric/Mental Health Clinical Nurse Specialist	$6.9K	$186.8K
Hayley Hamilton	VT	Clinical Social Worker	$0	$183.7K
Lamoille Health Partners Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$163.2K
Lauren Johnson	VT	Clinical Child & Adolescent Psychologist	$0	$162K
Lamoille Health Partners, Inc	VT	Neurology Physician	$0	$135.8K

Nearby Providers

Other providers in the same ZIP code as Lamoille Health Partners, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lamoille County Health Mental Health Services	VT	Community/Behavioral Health Agency	$0	$42.7M
Green Mountain Support Services Inc.	VT	Case Manager/Care Coordinator	$0	$25.9M
Lamoille County Mental Health Services	VT	Community/Behavioral Health Agency	$0	$22.2M
Lamoille Family Center Inc	VT	Public Health or Welfare Agency	$0	$5.2M
Maple Leaf Family Dentistry	VT	General Practice Dentistry	$0	$1.2M
Tamarack Family Medicine	VT	Clinic/Center	$0	$1.1M
Copley Hospital, Inc.	VT	Critical Access Hospital	$0	$525.5K
Melissa Mason	VT	Mental Health Counselor	$0	$488.6K
Experiential Counseling LLC	VT	Mental Health Counselor	$0	$440.7K
Carol Lehmann	VT	Occupational Therapist	$0	$412.1K

Lamoille Health Partners, Inc — Billing Profile & Reimbursement Data

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Lamoille Health Partners, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References