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.

Middlebury Family Health (NPI 1932159142)

Field	Value
Entity Type	Organization
Organization	Middlebury Family Health
Address	1330 Exchange St Ste 201
City	Middlebury
State	VT
ZIP	05753
Taxonomy	Health Maintenance Organization
NPI Enumerated	May 10, 2006

Payer Source	Total Paid
Medicaid	$547.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	6,780	$80	$508.6K
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…	550	$50	$28.7K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	850	$10	$4.2K
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…	80	$40	$3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	110	$20	$1.6K
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	$960
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…	180	$1	$180
1036F	N/A	40	$0	$0
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	100	$0	$0
G8482	Influenza immunization administered or previously received	30	$0	$0

Showing 1–10 of 11

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

Middlebury Family Health — 0 of 7 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

11 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…	44	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…	179	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…	17	50	50	$80	$50K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	63	90	330	$10	$10K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	23	80	190	$1	$3.7K
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.	6	20	50	$10	$730
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…	52	90	320	$1	$690
1036F	N/A	10	10	180	$1	$1
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	17	20	190	$0	$0
G8482	Influenza immunization administered or previously received	2	10	20	$0	$0

Showing 1–10 of 11

Related Providers

Other providers that share a Tax Identification Number (TIN) with Middlebury Family Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Deborah Huber	VT	Family Medicine Physician	$122.4K	$0
Daniel Huber	VT	Family Medicine Physician	$92.2K	$0
Katie Miller	VT	Internal Medicine Physician	$91.3K	$0
Peter Wilhelm	VT	Family Medicine Physician	$88.5K	$0
Eileen Doherty Fuller	VT	Family Medicine Physician	$83.5K	$0
Linn Larson	VT	Family Medicine Physician	$74.4K	$0
Lena Wasmus	VT	Family Nurse Practitioner	$64.3K	$0

Nearby Providers

Other providers in the same ZIP code as Middlebury Family Health, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Specialized Community Care, Inc	VT	Community/Behavioral Health Agency	$0	$60.9M
Counseling Service Of Addison County	VT	Developmental Disabilities Clinic/Center	$0	$59.6M
Counseling Service Of Addison County, Inc	VT	Clinic/Center	$0	$22.1M
Middlebury Pediatric Dentistry, PLLC	VT	Pediatric Dentistry	$0	$2.9M
Rainbow Pediatrics	VT	Pediatric Adolescent Medicine Physician	$0	$1.8M
Middlebury Volunteer Ambulance Association, Inc	VT	Ambulance	$508.9K	$1.3M
Porter Hospital, Inc	VT	Family Medicine Physician	$0	$1.3M
Brian Collins	VT	Pediatric Dentistry	$0	$606.8K
Amy Gregory	VT	Ophthalmology Physician	$306.6K	$0
Elizabeth Keathley	VT	Clinical Psychologist	$0	$303.3K

Middlebury Family Health — Billing Profile & Reimbursement Data

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Middlebury Family Health — 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