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.

Northwestern Medical Center, Inc. (NPI 1821581174)

Field	Value
Entity Type	Organization
Organization	Northwestern Medical Center, Inc.
Address	10 Crest Rd
City	Saint Albans
State	VT
ZIP	05478
Taxonomy	Otolaryngology Physician
NPI Enumerated	June 12, 2018

Payer Source	Total Paid
Medicaid	$68K
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	610	$40	$21.2K
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…	850	$20	$13.6K
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…	990	$10	$11.8K
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…	420	$20	$9.3K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	1,020	$10	$5.1K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	1,630	$1	$4.9K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	280	$10	$1.7K
92579	The provider performs a battery of tests to evaluate hearing loss in infants and toddlers. He uses sound sources to evaluate the auditory response, with reinforcement by animated toys.	40	$10	$380

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

Northwestern Medical Center, Inc. — 0 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

8 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…	153	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…	145	320	760	$20	$88.2K
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…	6	50	50	$80	$50K
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…	16	70	70	$50	$36K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	3	10	540	$10	$11.4K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	3	10	900	$10	$10.9K
92579	The provider performs a battery of tests to evaluate hearing loss in infants and toddlers. He uses sound sources to evaluate the auditory response, with reinforcement by animated toys.	2	10	30	$20	$7.6K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	2	10	80	$10	$2.5K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northwestern Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwestern Medical Center, Inc.	VT	Pediatrics Physician	$0	$1.4M
Northwestern Medical Center, Inc.	VT	General Acute Care Hospital	$0	$1.1M
Northwestern Medical Center, Inc.	VT	Urgent Care Clinic/Center	$0	$757.2K
Northwestern Medical Center, Inc.	VT	Pediatrics Physician	$0	$596.5K
Michael Hooker	VA	Orthopaedic Surgery Physician	$382.5K	$0
Northwestern Medical Center Inc	VT	General Acute Care Hospital	$0	$349.6K
Gregory Brophey	VT	Ophthalmology Physician	$234.2K	$0
Michael Barnum	FL	Orthopaedic Surgery of the Spine Physician	$200.3K	$0
Northwestern Medical Center, Inc.	VT	Family Medicine Physician	$0	$176.8K
Stephanie Neider	VT	Dermatology Physician	$145.1K	$0

Nearby Providers

Other providers in the same ZIP code as Northwestern Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northwestern Counseling & Support Services	VT	Community/Behavioral Health Agency	$0	$129.9M
Northwestern Counseling & Support Services Inc	VT	Community/Behavioral Health Agency	$0	$70.4M
Amcare Medical Systems, Inc.	VT	Land Ambulance	$576.2K	$2.2M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$180.2K	$2.5M
Remy Vallee Dmd Inc	VT	Dentist	$0	$1.1M
Calm Reflections Psychotherapy, LLC	VT	Clinical Social Worker	$0	$840.8K
Northern Valley Eyecare, Inc.	VT	Optometrist	$0	$703.1K
Michelle Pelkey	VT	Clinical Social Worker	$0	$550.9K
Gillian Ireland	VT	Mental Health Counselor	$0	$388.4K
Avalon Natural Medicine Of Vermont, PLLC	VT	Naturopath	$0	$373K

Northwestern Medical Center, Inc. — Billing Profile & Reimbursement Data

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Northwestern Medical Center, 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