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.

Northeastern Vermont Regional Hospital, Inc (NPI 1992747737)

Field	Value
Entity Type	Organization
Organization	Northeastern Vermont Regional Hospital, Inc
Address	1315 Hospital Dr
City	St Johnsbury
State	VT
ZIP	05819
Taxonomy	Surgery Physician
NPI Enumerated	June 12, 2006

Payer Source	Total Paid
Medicaid	$98.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 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…	3,270	$20	$52.3K
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…	530	$20	$11.7K
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…	330	$30	$10.5K
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…	880	$10	$7K
V5266	Battery for use in hearing device	710	$10	$6.4K
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…	180	$20	$3.9K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	360	$10	$2.2K
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.	930	$1	$1.9K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	170	$10	$1.7K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	30	$10	$320

Showing 1–10 of 16

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

Northeastern Vermont Regional Hospital, Inc — 0 of 16 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

16 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…	230	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…	81	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…	9	50	50	$80	$50K
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…	99	110	170	$70	$38.6K
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…	23	70	70	$50	$36K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	4	10	1,000	$10	$14.5K
11721	The provider surgically debrides (debulks or removes) 6 or more abnormal, diseased, or infected nails.	8	10	300	$10	$12K
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…	4	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.	4	10	900	$10	$10.9K
92552	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the lowest threshold at which the patient can hear.	5	10	360	$10	$8.3K

Showing 1–10 of 16

Related Providers

Other providers that share a Tax Identification Number (TIN) with Northeastern Vermont Regional Hospital, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$3.4M
Northeastern Vermont Regional Hospital, Inc	VT	Primary Care Clinic/Center	$0	$2.8M
Northeastern Vermont Regional Hospital, Inc	VT	Rural Health Clinic/Center	$0	$1.3M
Northeastern Vermont Regional Hospital Inc.	VT	Primary Care Clinic/Center	$0	$821.4K
Northeastern Vermont Regional Hospital Inc	VT	Rural Health Clinic/Center	$0	$703.3K
Northeastern Vermont Regional Hospital, Inc.	VT	Critical Access Hospital	$0	$442K
Jeremy Collins	NH	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$328.2K	$0
Rose Sheehan	VT	Counselor	$0	$324.2K
Christopher Kareores	MA	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$78.4K	$193.8K
Daniel Wilson	VT	Emergency Medicine Physician	$86.9K	$116.4K

Nearby Providers

Other providers in the same ZIP code as Northeastern Vermont Regional Hospital, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Darren Boles Dds PLLC	VT	Dental Clinic/Center	$0	$5.2M
Baart Behavioral Health Services, Inc.	VT	Substance Use Disorder Rehabilitation Clinic/Center	$559K	$3.5M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$2.5M
Caledonia-essex Area Ambulance Service, Inc.	VT	Land Ambulance	$406.4K	$1.6M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.8M
Northern Counties Health Care, Inc.	VT	Federally Qualified Health Center (FQHC)	$0	$1.3M
Jason Parks	VT	Radiation Oncology Physician	$1.2M	$0
Shippee Family Eye Care PC	VT	Optometrist	$0	$1M
St Johnsbury Psychology Associates, PLLC	VT	Clinical Psychologist	$0	$807.7K
Vermont Radiologists	VT	Diagnostic Radiology Physician	$0	$795.5K

Northeastern Vermont Regional Hospital, Inc — Billing Profile & Reimbursement Data

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Northeastern Vermont Regional Hospital, 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