Clinic
Gifford Health Care, INC
Gifford Health Care, INC was paid $8.43M by Medicaid between Jan 2018 and Dec 2024, across 31 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 99% of everything it billed.
33Billing provider infoGIFFORD HEALTH CARE, INC
RANDOLPH, VT 05060
RANDOLPH, VT 05060
33aNPI1326478702assigned 11/20/2013
33bProvider typeFederally Qualified Health Center (FQHC)
28Total paid$8.43M
24GClaims104,272
24DCodes billed31
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Federally Qualified Health Center (FQHC) providers in Vermont
Rank by total paid#5 of 33
Median peer was paid$1.23M
This provider vs. median6.9×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 16,991 | $1.19M | |
| 2019 | 18,710 | $1.20M | |
| 2020 | 13,306 | $989K | |
| 2021 | 14,281 | $1.15M | |
| 2022 | 15,547 | $1.34M | |
| 2023 | 14,155 | $1.39M | |
| 2024incomplete | 11,282 | $1.17M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 99% | 52,091 | 42,982 | $8.36M |
| G0467 | Community health center visit, returning patientFederally 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 time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit | <1% | 2,506 | 2,114 | $37K |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | <1% | 11,827 | 10,422 | $24K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 18,079 | 16,072 | $11K |
| 90837 | Psychotherapy session, about an hourPsychotherapy, 53 minutes with patient | <1% | 284 | 115 | $668.80 |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 945 | 820 | $517.80 |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 60 | 46 | $379.20 |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 31 | 31 | $140.70 |
| 90686 | 0% | 1,730 | 1,598 | $0.00 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 0% | 5,803 | 5,375 | $0.00 |
| 96127 | 0% | 375 | 324 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 1,915 | 1,824 | $0.00 |
19 more codes
| 90656 | 0% | 160 | $0.00 | |
| 90834 | Psychotherapy session, about 45 minutes | 0% | 567 | $0.00 |
| G0008 | Administration of influenza virus vaccine | 0% | 24 | $0.00 |
| 90723 | 0% | 38 | $0.00 | |
| 99308 | Subsequent nursing facility care, per day, straightforward | 0% | 27 | $0.00 |
| 90480 | 0% | 14 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 1,097 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 1,066 | $0.00 |
| 90670 | 0% | 311 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 2,233 | $0.00 |
| 99173 | 0% | 355 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 1,721 | $0.00 |
| 90648 | 0% | 229 | $0.00 | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | 0% | 110 | $0.00 |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 290 | $0.00 |
| 92552 | 0% | 226 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 77 | $0.00 |
| 90685 | 0% | 67 | $0.00 | |
| 90671 | 0% | 14 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialCOSTA, MICHAEL (CEO)
Parent organizationGIFFORD HEALTH CARE, INC
| Provider | Location | Paid |
|---|---|---|
| Gifford Health Care, INC | Barre, VT | $2.05M |
| Northern Counties Health Care, INC. | St Johnsbury, VT | $1.85M |
| Gifford Health Care, INC | Bethel, VT | $1.83M |
| Gifford Health Care, INC. | Randolph, VT | $934K |
| Gifford Health Care, INC | Chelsea, VT | $819K |
| Gifford Health Care, INC | Rochester, VT | $345K |
| Gifford Health Care, INC | Randolph, VT | $258K |
| Gifford Medical Center INC. | Randolph, VT | $218K |
| Gifford Health Care, INC | White River Junction, VT | $111K |
| Gifford Medical Center INC | Randolph, VT | $15K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.