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.

Vicente T Falgui Md PC (NPI 1790291078)

Field	Value
Entity Type	Organization
Organization	Vicente T Falgui Md PC
Address	990 Main Street
City	Danville
State	VT
ZIP	24541
Taxonomy	Internal Medicine Physician
NPI Enumerated	December 21, 2017

Payer Source	Total Paid
Medicaid	$260.6K
Medicare	$0

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
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…	5,070	$40	$202.6K
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…	270	$70	$18.4K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	2,390	$10	$16.8K
82947	The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip.	2,480	$1	$5K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	170	$30	$4.7K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	40	$70	$2.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	2,040	$1	$2K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	30	$70	$1.7K
J3420	Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	1,480	$1	$1.5K
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.	100	$10	$800

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

Vicente T Falgui Md PC — 2 of 22 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
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…	213	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…	60	320	760	$20	$88.2K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	22	30	140	$10	$15.6K
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…	21	20	450	$10	$12.7K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	1	10	170	$30	$4.7K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	1	20	110	$10	$4.2K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	9	80	190	$1	$3.7K
82947	The lab analyst performs a test to measure the amount of glucose in a patient's blood using a method other than a reagent strip.	1	10	400	$1	$3.5K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	1	10	40	$60	$2.3K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	8	20	150	$1	$1.8K

Showing 1–10 of 22

Nearby Providers

Other providers in the same ZIP code as Vicente T Falgui Md PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Danville Regional Medical Center, LLC	VA	Rural Acute Care Hospital	$0	$65.1M
Crossroads Treatment Center Of Danville, PC	VA	Substance Use Disorder Rehabilitation Clinic/Center	$173.7K	$18.6M
Danville Physician Practices LLC	VA	Anesthesiology Physician	$0	$13M
L&g Support And Resources Co.	VA	Community/Behavioral Health Agency	$0	$12M
Team Nurse, Inc.	VA	Personal Care Attendant	$0	$10.3M
Calm Source, LLC	VA	Community/Behavioral Health Agency	$0	$10.1M
Royal Care Incorporated	VA	Home Health Agency	$0	$9.8M
Piedmont Access To Health Services, Inc	VA	Federally Qualified Health Center (FQHC)	$0	$9.1M
Prince Charles Home Healthcare Agency, LLC	VA	Home Health Agency	$0	$8.6M
Team Nurse, Inc.	VA	Personal Care Attendant	$0	$7.9M

Vicente T Falgui Md PC — Billing Profile & Reimbursement Data

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Vicente T Falgui Md PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References