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 1699755348)

Field	Value
Entity Type	Organization
Organization	Northeast Washington County Community Health, Inc.
Address	157 Towne Ave.
City	Plainfield
State	VT
ZIP	05667
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 19, 2006

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

Key Findings

This provider is effectively single‑payer: there is no Medicare billing on file while total Medicaid revenue equals $5.3M, so Medicaid accounts for the entirety of reported lifetime federal program revenue. The absence of Medicare receipts makes Medicaid the decisive driver of financial and utilization analyses for this entity.

Revenue is extremely concentrated in a single Medicaid code: T1015 accounts for $5.2M and represents 98.5% of this provider's total Medicaid revenue, with the top three Medicaid codes together accounting for 99.7% of Medicaid revenue. That concentration implies the organization’s financial viability hinges on bundled clinic/encounter payments rather than a broad mix of fee‑for‑service procedures.

The provider’s code mix and FQHC taxonomy align with a bundled, clinic-centric operating model: T1015 (Clinic visit/encounter, all‑inclusive) is the dominant revenue source and G0467 (FQHC visit, established patient) also appears on the ledger, reflecting standard FQHC per‑visit bundling. Many common outpatient E/M codes (for example, 99214: 9.9K claims, $0 avg paid/claim; 99213: 2.1K claims, $0 avg paid/claim) show substantial claim counts with $0 paid, consistent with services being reimbursed under all‑inclusive FQHC payment constructs rather than separate fee‑for‑service payments.

Behavioral health and telehealth activity are visible but low‑revenue per claim: 90834 shows 8.6K claims and $8.6K revenue and is noted as "notably above typical" state volume, indicating high psychotherapy encounter volume even though average paid per claim is $1. Telehealth-specific billing is present via G2025 (571 claims, $13 avg paid/claim, $7.4K revenue), signaling a modest telehealth footprint tied to FQHC remote visit reimbursements.

Competitive standing is mixed across codes: for T1015 the provider ranks #15 of 70 in‑state (80th percentile) with a label of "typical, unremarkable volume," indicating a solid but not dominant statewide position for the primary clinic visit code. For higher‑intensity office E/Ms, 99215 ranks #8 of 111 (94th percentile) and is labeled "typical, unremarkable volume," while psychotherapy 90834 ranks #8 of 165 (96th percentile) and is labeled "notably above typical state volume," highlighting that the organization is comparatively stronger in psychotherapy encounters than in routine clinic visits when judged by in‑state percentiles.

Operational billing patterns reinforce the FQHC business model: large counts of E/M and procedure codes with $0 paid (examples include 99214: 9.9K claims, $0 revenue; 99213: 2.1K claims, $0 revenue; 90837: 364 claims, $0 revenue) point to bundled reimbursement under T1015/G0467 rather than discrete fee‑for‑service payments. Analysts should therefore treat claim volumes for individual E/M codes as activity indicators rather than direct revenue contributors.

The provider is long‑tenured in the NPI registry, enumerated on 2006-01-19 (~20 years ago), which supports stability in network presence and eligibility to operate as an FQHC over an extended period. This tenure, combined with concentrated Medicaid revenue, suggests an established community clinic operation with a sustained reliance on Medicaid program funding.

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	30,540	$170	$5.2M
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…	2,410	$20	$52.9K
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…	1,950	$10	$11.7K
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…	8,580	$1	$8.6K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	570	$10	$7.4K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	170	$1	$330
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	30	$10	$220
99205	The provider sees a new 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 provider…	30	$1	$60
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	20	$0	$0
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	20	$0	$0

Showing 1–10 of 16

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. — 1 of 8 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	15	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…	27	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…	434	670	760	$70	$143.9K
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…	101	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…	17	50	1,020	$20	$87.6K
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…	8	110	170	$70	$38.6K
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…	8	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…	54	110	260	$20	$19.5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	80	90	330	$10	$10K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	83	90	60	$50	$9.4K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northeast Washington County Community Health, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Tara Meyer	VT	Family Nurse Practitioner	$6.6K	$0
Jessica Fisch	VT	Medical Physician Assistant	$4K	$0
Sara Bylow	VT	Medical Physician Assistant	$3.2K	$0

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	Dentist	$0	$5.8M
Tina Desmarais	VT	Mental Health Counselor	$0	$514.3K
Northeast Washington County Community Health Inc	VT	Multi-Specialty Clinic/Center	$0	$53.3K

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

Related Providers

Nearby Providers

Frequently Asked Questions

References