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.

Gifford Medical Center Inc. (NPI 1942329446)

Gifford Medical Center Inc. is a general acute care hospital provider located in Randolph, Vermont. This profile covers 0 Medicare and 36 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Gifford Medical Center Inc.
Address	44 S Main St
City	Randolph
State	VT
ZIP	05060
Taxonomy	General Acute Care Hospital
NPI Enumerated	March 28, 2007

Payer Source	Total Paid
Medicaid	$218.4K
Medicare	$0

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

36 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	4,370	$20	$70K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2,270	$30	$65.7K
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…	960	$20	$22.1K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	710	$20	$14.1K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	3,960	$1	$11.9K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	590	$20	$10.6K
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…	220	$20	$4.2K
98942	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in five spinal regions.	330	$10	$3.3K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	390	$10	$3.1K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	40	$50	$1.7K

Showing 1–10 of 36

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

Gifford Medical Center Inc. — 1 of 25 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

36 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	68	70	11,650	$150	$3.3M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	14	30	830	$40	$232.2K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	10	30	1,150	$30	$147K
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…	316	320	680	$30	$146.1K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	19	20	630	$30	$118.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	23	30	190	$50	$104.3K
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…	149	320	760	$20	$88.2K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	8	20	710	$40	$85K
98942	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in five spinal regions.	17	20	1,250	$40	$58.3K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	69	80	1,500	$30	$52.6K

Showing 1–10 of 36

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$8.4M
Gifford Health Care, Inc	VT	Federally Qualified Health Center (FQHC)	$0	$820.3K
Rebecca A Foulk Md PC	VT	Pediatrics Physician	$0	$753.2K
Syed Akbar	IL	Diagnostic Radiology Physician	$280.8K	$223.7K
Alexander Harvin	IA	Diagnostic Radiology Physician	$353.1K	$0
Peter Piampiano	TN	Diagnostic Radiology Physician	$254.4K	$20.1K
Elise Hotaling	MN	Diagnostic Radiology Physician	$171.1K	$23.7K
Naveen Selvam	PA	Diagnostic Radiology Physician	$190.6K	$80
Paula Despault	VT	Mental Health Counselor	$0	$151.9K
Yachao Zhang	DC	Diagnostic Radiology Physician	$96.8K	$44.1K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clara Martin Center	VT	Community/Behavioral Health Agency	$0	$11.8M
Gifford Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$935.6K
Clara Martin Center	VT	Community/Behavioral Health Agency	$0	$807.8K
Jessica Heney	VT	Family Medicine Physician	$0	$273.6K
Gifford Health Care, Inc	VT	General Practice Physician	$0	$256.1K
Shana Kotelchuck	VT	Clinical Social Worker	$0	$212.8K
Maxi Green Inc	VT	Community/Retail Pharmacy	$163.2K	$0
Resonant Medicine	VT	Naturopath	$0	$86.5K
Marjorie Crowe	VT	Clinical Social Worker	$27.7K	$51.2K
Soares Ocular Surgery	VT	Ophthalmologic Surgery Clinic/Center	$0	$63.9K

Gifford Medical Center Inc. — Billing Profile & Reimbursement Data

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Gifford 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

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