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 1770541567)

Field	Value
Entity Type	Organization
Organization	Lamoille Health Partners, Inc
Address	1878 Mountain Rd
City	Stowe
State	VT
ZIP	05672
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 2, 2006

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

Key Findings

LAMOILLE HEALTH PARTNERS, INC shows no Medicare billing on file and reports $4.9M in lifetime Medicaid revenue, making Medicaid effectively the sole payer with recorded revenue for this provider. This profile indicates the organization is operating primarily within the Medicaid payment stream rather than fee-for-service Medicare.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 99.5% of the provider’s Medicaid revenue. Those drivers are T1015 with $4.7M (97.5% of Medicaid revenue), G0467 with $74.4K (1.5%), and 90471 with $23.5K (0.5%), which together dominate the financial picture.

As a Federally Qualified Health Center (FQHC) whose top code is T1015 (Clinic visit/encounter, all-inclusive), the billing mix is consistent with bundled, per-encounter FQHC reimbursement for primary care and comprehensive clinic visits. The presence of G0467 (FQHC visit, established patient) and vaccination codes like 90471 further supports that the operation is centered on routine primary care visits, immunizations, and other front-line ambulatory services delivered under an FQHC payment model.

Several high-volume E/M and vaccine codes appear with meaningful claim counts but report $0 in Medicaid revenue (for example 99213: 17.9K claims $0, 99214: 5.8K claims $0, 90686: 889 claims $0, and 99000: 1.1K claims $0). This pattern is consistent with encounter reporting conventions and bundled FQHC payments, where many individual procedure-level line items are submitted for encounter tracking rather than generating separate fee-for-service Medicaid payments.

On competitive standing within Vermont, T1015 ranks #18 of 70 providers (75th percentile), G0467 ranks #11 of 49 (79th percentile), and 90471 ranks #20 of 88 (78th percentile). These percentiles indicate LAMOILLE HEALTH PARTNERS is a solid, above-median participant statewide for its primary FQHC visit and vaccine activity but not a dominant outlier among peers.

The provider maintains long tenure in the NPI registry, enumerated on 2006-05-02 (~20 years ago), indicating a long-established presence in the local market that aligns with steady Medicaid activity rather than a recent entrant.

Ancillary services and point-of-care testing contribute only modestly to revenue: 80305 (presumptive drug test) shows 1.5K claims and $18K revenue (0.4% of Medicaid revenue) and basic lab/diagnostic items such as 36415 (669 claims, $669) and 83036 (28 claims, $252) appear with small dollar impact. These line items support a primary-care-focused operation that captures some ancillary testing but relies overwhelmingly on bundled clinic encounter payments for revenue.

Telehealth/distance-site billing and other specialized items are minimal: G2025 shows 26 claims for $208 (rank #24 of 26, 4th percentile), indicating limited billing as a telehealth distant-site FQHC/RHC for Medicaid. Overall, the claim and revenue mix points to in-person, primary care encounters as the core service with very limited remote-site revenue capture.

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	28,220	$170	$4.7M
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…	3,100	$20	$74.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,810	$10	$23.5K
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…	1,500	$10	$18K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	160	$20	$2.6K
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.	90	$20	$1.4K
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…	20	$50	$770
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	670	$1	$670
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	290	$1	$570
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.	30	$10	$440

Showing 1–10 of 22

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 14 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	18	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…	48	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…	23	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…	11	50	1,020	$20	$87.6K
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.	19	20	170	$10	$17.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	39	40	290	$20	$16K
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…	19	20	180	$40	$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…	9	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.	15	30	160	$10	$10K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	20	90	330	$10	$10K

Showing 1–10 of 22

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	$5.4M
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
Stowe Natural Family Wellness, PLLC	VT	Naturopath	$0	$638.8K
Integral Wellness, LLC	VT	Mental Health Counselor	$0	$553K
Sean Ryan	VT	Clinical Social Worker	$0	$406.5K
Bps Health LLC	VT	Psychologist	$0	$316.9K
Myeyedr Optometry Of Vermont LLC	VT	Optometrist	$0	$239.3K
Stowe Family Dentistry PC	VT	General Practice Dentistry	$0	$230.2K
James Charkalis	VT	Chiropractor	$10.6K	$146K
Jan Johnson	VT	Physical Therapist	$98.8K	$0
Stowe Therapeutic Solutions, LLC	VT	Community/Behavioral Health Agency	$0	$63.1K
David Bisbee	VT	Family Medicine Physician	$59.5K	$0

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