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.

Northeastern Vermont Regional Hospital Inc. (NPI 1659459428)

Field	Value
Entity Type	Organization
Organization	Northeastern Vermont Regional Hospital Inc.
Address	195 Industrial Pkwy Ste 1
City	Lyndonville
State	VT
ZIP	05851
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	November 1, 2006

Payer Source	Total Paid
Medicaid	$821.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	16,930	$40	$677.3K
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…	9,710	$10	$68K
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…	2,940	$20	$44.1K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	570	$30	$16.5K
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	420	$20	$8.9K
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…	940	$1	$1.9K
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…	40	$50	$1.6K
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.	480	$1	$1.4K
90832	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…	80	$10	$550
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	10	$30	$430

Showing 1–10 of 15

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

Northeastern Vermont Regional Hospital Inc. — 0 of 13 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	28	70	11,650	$150	$3.3M
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	5	10	80	$30	$164.6K
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…	85	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…	42	320	760	$20	$88.2K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	5	10	60	$40	$45.1K
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…	10	70	70	$50	$36K
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…	133	170	360	$20	$35.9K
90832	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…	81	110	260	$20	$19.5K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	23	20	450	$10	$12.7K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	81	90	330	$10	$10K

Showing 1–10 of 15

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northeastern Vermont Regional Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$3.4M
Northeastern Vermont Regional Hospital, Inc	VT	Primary Care Clinic/Center	$0	$2.8M
Northeastern Vermont Regional Hospital, Inc	VT	Rural Health Clinic/Center	$0	$1.3M
Northeastern Vermont Regional Hospital Inc	VT	Rural Health Clinic/Center	$0	$703.3K
Northeastern Vermont Regional Hospital, Inc.	VT	Critical Access Hospital	$0	$442K
Jeremy Collins	NH	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$328.2K	$0
Rose Sheehan	VT	Counselor	$0	$324.2K
Christopher Kareores	MA	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$78.4K	$193.8K
Daniel Wilson	VT	Emergency Medicine Physician	$86.9K	$116.4K
David Peritz	CO	Cardiovascular Disease Physician	$163.7K	$0

Nearby Providers

Other providers in the same ZIP code as Northeastern Vermont Regional Hospital Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northeast Kingdom Learning Services, Inc Fit	VT	Public Health or Welfare Agency	$0	$2.1M
Ellen Moore	VT	Mental Health Counselor	$0	$901.5K
Kristi Zola, PLLC	VT	Community/Behavioral Health Agency	$0	$574.5K
Lincare Inc.	VT	Durable Medical Equipment & Medical Supplies	$0	$421.2K
Lucille Mckee	VT	Addiction (Substance Use Disorder) Counselor	$0	$280.8K
Julie Guerette	VT	Psychologist	$0	$246.2K
Deborah Lee	VT	Addiction (Substance Use Disorder) Counselor	$0	$194.2K
Northern Physical Therapy PC	VT	Physical Therapy Clinic/Center	$0	$147.3K
Northeastern Vermont Regional Hospital Inc	VT	Physical Therapist	$0	$125.5K
Melanie Willis Counseling, LLC	VT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$114.7K

Northeastern Vermont Regional Hospital Inc. — Billing Profile & Reimbursement Data

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Northeastern Vermont Regional Hospital Inc. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References