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.

University Of Vermont Medical Center Inc (NPI 1659309615)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Of Vermont Medical Center Inc
Address	111 Colchester Ave
City	Burlington
State	VT
ZIP	05401
Taxonomy	Internal Medicine Physician
NPI Enumerated	June 29, 2006

Payer Source	Total Paid
Medicaid	$17.6M
Medicare	$0

This provider effectively operates as a Medicaid-centric organization: there is no Medicare billing on file and lifetime Medicaid revenue is $17.6M, indicating that Medicaid is the material payer for this NPI. The record shows the NPI was enumerated 2006-06-29 (~20 years ago), so this is a long-tenured billing entity with an established presence in-state.

Revenue is highly concentrated in a small set of E/M and ED codes: the top three Medicaid codes (99214, 99213, 99284) account for 50.1% of total Medicaid revenue. Specifically, 99214 produced $3.7M (26.3%), 99213 produced $1.8M (13.2%), and 99284 produced $1.5M (10.6%) of the $17.6M Medicaid total—these three codes are core to the provider’s revenue mix.

The service-line mix reflects very high-volume outpatient and acute care activity. Large claim volumes for 99214 (121.9K claims, $30 avg paid/claim, $3.7M) and 99213 (91.5K claims, $20 avg paid/claim, $1.8M) signal a major ambulatory practice seeing established and new patients, while substantial payments for imaging and pathology codes such as 88305 ($709.5K) and 74177 ($284K) indicate integrated diagnostic capacity supporting those clinical services.

Emergency, inpatient, and critical-care services are meaningful revenue drivers alongside outpatient work. High-volume ED codes 99284 ($1.5M) and 99285 ($1.4M), plus inpatient visit codes 99232 ($591.2K) and 99233 ($188.8K) and critical care 99291 ($312.1K), show the provider bills across the care continuum from ED through inpatient critical care, consistent with a full-service acute care operation.

This provider is a dominant statewide player for many individual Medicaid codes. Examples include 99214 (ranks #1 of 323 providers in-state, 100th percentile; extreme outlier), 99284 (ranks #1 of 31, 100th percentile; extreme outlier), 99285 (ranks #1 of 30, 100th percentile; extreme outlier), and multiple imaging/pathology codes where it also ranks #1 — these rank/percentile positions indicate market leadership and volumes far above typical state peers.

There is evidence of specialized inpatient and perinatal services beyond routine office visits: chemotherapy administration 96413 generated $137.5K, fetal/obstetric imaging codes like 76816 generated $290.6K and 76811 generated $121.6K, and neonatal care code 99479 produced $111.4K. The presence of S0311 (comprehensive management and care coordination for advanced illness, 75 claims, $113.9K) also signals billing for advanced illness management and care coordination services.

High throughput is a consistent operational trait: very large claim counts combined with modest per-claim payments suggest a volume-driven model. Examples include 99214 at 121.9K claims ($30 avg paid/claim), 93010 at 69.6K claims ($2 avg paid/claim, $139.2K revenue), and 70450 at 14.7K claims ($11 avg paid/claim, $162.2K revenue), implying substantial patient flow and operational scale even when unit prices are low.

For payers and network analysts, the combination of an effectively single-payer (Medicaid-only) revenue base, concentrated reliance on a few high-volume E/M and ED codes, and repeated 100th-percentile/state-leading ranks suggests this provider is a capacity anchor in Vermont. Given its long tenure (NPI enumerated 2006-06-29 (~20 years ago)) and dominant code-level positions, payers should consider this provider’s impact on network access, utilization management, and contract negotiation strategies rather than treating it as a marginal Medicaid participant.

Medicaid: Complete Services Breakdown

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

369 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…	121,890	$30	$3.7M
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…	91,510	$20	$1.8M
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.	47,380	$30	$1.5M
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.	31,190	$50	$1.4M
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…	32,250	$20	$709.5K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	29,560	$20	$591.2K
99203	The provider sees a new 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 provider…	13,440	$40	$537.8K
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…	7,310	$60	$423.9K
99204	The provider sees a new 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 provider…	5,990	$60	$377.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	5,290	$60	$312.1K

Showing 1–10 of 369

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

University Of Vermont Medical Center Inc — 19 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

369 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	6	10	660	$120	$303.7K
H0004	Behavioral health counseling and therapy, per 15 minutes	13	20	1,410	$80	$247.4K
H0005	Alcohol and/or drug services; group counseling by a clinician	11	10	630	$60	$243.1K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	7	10	16,150	$20	$239.2K
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.	1	30	830	$40	$232.2K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1	10	2,400	$80	$215.1K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	8	10	160	$120	$149.2K
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.	7	30	1,150	$30	$147K
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	320	680	$30	$146.1K
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…	375	670	760	$70	$143.9K

Showing 1–10 of 369

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Northeastern Vermont Regional Hospital, Inc	VT	Primary Care Clinic/Center	$0	$2.8M
James Stafford	TX	Radiation Oncology Physician	$1.5M	$0
University Of Vermont Medical Center Inc	VT	General Acute Care Hospital	$0	$780.5K
Paul Unger	VT	Hematology & Oncology Physician	$744.6K	$0
University Of Vermont Health Network Specialty Care Transport, LLC	VT	Land Ambulance	$144K	$510.7K
Carlos Torres	TX	Anatomic Pathology & Clinical Pathology Physician	$580.7K	$0
Brian Kim	VT	Ophthalmology Physician	$488.3K	$0
Glenn Goldman	VT	MOHS-Micrographic Surgery Physician	$454.5K	$0
University Of Vermont Medical Center	VT	General Practice Dentistry	$0	$433.2K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Howard Center Inc	VT	Developmentally Disabled Services Day Training Agency	$0	$332.2M
Howard Center Inc	VT	Adolescent and Children Mental Health Clinic/Center	$0	$130.1M
Vermont Department Of Mental Health	VT	Adult Mental Health Clinic/Center	$0	$105.1M
Community Health Centers Of Burlington Inc	VT	Federally Qualified Health Center (FQHC)	$0	$39.8M
Howard Center Inc	VT	Methadone Clinic	$517.9K	$35M
Howard Center Inc	VT	State or Local Public Health Clinic/Center	$0	$23.4M
Transition Ii	VT	Case Manager/Care Coordinator	$0	$17.3M
The Dental Center At Community Health Center Of Burlington	VT	Dental Clinic/Center	$0	$6.7M
City Of Burlington Vermont	VT	Land Ambulance	$677.2K	$4.3M
Spectrum, Inc.	VT	Addiction (Substance Use Disorder) Counselor	$0	$2.4M

University Of Vermont Medical Center 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