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.

Springfield Medical Care Systems Inc (NPI 1992030365)

Field	Value
Entity Type	Organization
Organization	Springfield Medical Care Systems Inc
Address	1 Hospital Ct
City	Bellows Falls
State	VT
ZIP	05101
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 2, 2009

Payer Source	Total Paid
Medicaid	$7.8M
Medicare	$0

Key Findings

This provider is effectively single‑payer at the present reporting scale: Medicare billing is none (no Medicare billing on file) while Medicaid revenue totals $7.8M, so all recorded federal reimbursement for this entity flows through Medicaid. That concentration in a single payer shapes both revenue volatility and contracting leverage relative to mixed‑payer peers.

Revenue is extremely concentrated in a single procedure class: the precomputed top three Medicaid codes account for 99.9% of the provider’s Medicaid revenue, with T1015 alone representing $7.6M (98.2% of Medicaid revenue), G0467 $115.8K (1.5%), and 99213 $17.2K (0.2%). This indicates that virtually all Medicaid dollars to the clinic are captured through the FQHC visit/bundle represented by T1015 rather than distributed across a wide set of fee‑for‑service codes.

The code mix and taxonomy confirm a classic FQHC operating model: the provider is an FQHC and the dominant code is T1015 (clinic visit/encounter, all‑inclusive), which implies bundled, per‑encounter payment for a wide scope of primary care and wraparound services. The presence of G0467 (FQHC visit, established patient) and G0470 (FQHC mental health visit) in the revenue list further supports a model delivering both general primary care and integrated behavioral‑health visits under FQHC reimbursement rules.

Competitive standing in state Medicaid is modest rather than dominant. T1015 ranks #13 of 70 providers (83th percentile; typical, unremarkable volume for this code), G0467 ranks #7 of 49 (88th percentile; typical, unremarkable volume), and 99213 ranks #25 of 319 (92th percentile; typical, unremarkable volume). These ranks show that the clinic operates at mid‑to‑upper percentile volumes for common visit codes in Vermont but is not a top‑tier statewide revenue leader for these services.

There is a clear mismatch between high claim volumes for many E/M, preventive and ancillary CPTs and the recorded paid dollars: several widely used codes report sizable claim counts but $0 avg paid/claim (examples include 99214 with 15.6K claims, 90833 with 1.9K claims, and 90460 with 1.8K claims). This pattern is consistent with the FQHC payment structure where many individual services are encompassed by an all‑inclusive encounter payment (T1015), and separate line‑item payments are therefore minimal or zero.

Telehealth and virtual‑care reimbursement appears limited in scale: G2025 (telehealth distant site for FQHC/RHC) shows 332 claims and $3.7K revenue ($11 avg paid/claim), while G0071 (virtual communications) has 67 claims and $335 revenue. These figures suggest some telehealth activity but a small contribution to overall Medicaid revenue relative to in‑person bundled visits.

The provider has an established operational presence: its NPI was enumerated on 2009-10-02 (~17 years ago), indicating long tenure in the market. Combined with steady Medicaid receipts of $7.8M, this tenure suggests an enduring FQHC role in the local safety‑net delivery system rather than a recent or transient entrant.

Medicaid: Complete Services Breakdown

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	47,110	$160	$7.6M
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…	4,820	$20	$115.8K
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…	17,200	$1	$17.2K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	330	$10	$3.7K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	130	$20	$2.6K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	60	$10	$740
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	70	$10	$660
G0071	Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center…	70	$10	$340
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…	150	$1	$150
2014F	No Summary found for this code	320	$0	$0

Showing 1–10 of 44

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

Springfield Medical Care Systems Inc — 0 of 9 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	13	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…	14	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…	18	20	630	$30	$118.5K
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…	25	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…	7	50	1,020	$20	$87.6K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	10	10	60	$40	$45.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	79	110	170	$70	$38.6K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	16	40	890	$10	$32.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17	40	170	$40	$31.6K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	17	40	280	$20	$19.5K

Showing 1–10 of 44

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$13.3M
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$3.6M
Springfield Medical Care Systems Inc	NH	Federally Qualified Health Center (FQHC)	$0	$3.1M
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$683.8K
Springfield Medical Care Systems Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$365.8K
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$204.8K
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$142.8K
Springfield Medical Care Systems Inc	VT	Federally Qualified Health Center (FQHC)	$0	$135.6K

Nearby Providers

Other providers in the same ZIP code as Springfield Medical Care Systems Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Health Care & Rehabilitation Services	VT	Developmental Disabilities Clinic/Center	$0	$136.1M
Health Care & Rehabilitation Services	VT	Adolescent and Children Mental Health Clinic/Center	$0	$25.4M
Health Care & Rehabilitaion Services	VT	Clinic/Center	$0	$5M
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Developmental Disabilities Clinic/Center	$0	$1M
Sandra Cotter,lcmhc, Ladc,llc	VT	Mental Health Counselor	$0	$509.4K
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Community/Behavioral Health Agency	$0	$507K
Waypoint Counseling LLC	VT	Mental Health Counselor	$0	$368.7K
Jordan River Dental	VT	General Practice Dentistry	$0	$185K
Timothy Johnson	VT	Optometrist	$51.3K	$99.5K
Health Care And Rehabilitation Services Of Southeastern Vermont, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$131.3K

Springfield Medical Care Systems Inc — Billing Profile & Reimbursement Data

Sign up for Springfield Medical Care Systems Inc — Billing Profile & Reimbursement Data policy alerts

Springfield Medical Care Systems Inc — Billing Profile & Reimbursement Data

Sign up for Springfield Medical Care Systems Inc — Billing Profile & Reimbursement Data policy alerts

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