Physician
Northwestern Medical Center, INC.
Northwestern Medical Center, INC. was paid $1.35M by Medicaid between Jan 2018 and Dec 2021, across 34 billing codes. Its largest line is 99214, doctor's office visit, returning patient (more involved) — 34% of everything it billed.
33Billing provider infoNORTHWESTERN MEDICAL CENTER, INC.
SAINT ALBANS, VT 05478
SAINT ALBANS, VT 05478
33aNPI1588039176assigned 12/08/2015
33bProvider typePediatrics Physician
28Total paid$1.35M
24GClaims55,546
24DCodes billed34
24AFirst – last monthJan 2018 – Dec 2021
Compared with peers
Next to other Pediatrics Physician providers in Vermont
Rank by total paid#1 of 27
Median peer was paid$62K
This provider vs. median22×
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.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official PIGEON, MARY controls 20+ related entities in our dataset. Read more
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 | 16,606 | $888K | |
| 2019 | 13,785 | $227K | |
| 2020 | 11,733 | $115K | |
| 2021 | 13,422 | $123K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 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 | 34% | 8,653 | 7,878 | $456K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 28% | 12,804 | 11,679 | $378K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 11% | 1,883 | 1,668 | $156K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 6.6% | 2,399 | 2,318 | $90K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 5.4% | 8,762 | 8,408 | $74K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.8% | 2,036 | 1,977 | $65K |
| 90472 | Immunization administration, each additional vaccine (list separately) | 3.4% | 4,169 | 3,988 | $46K |
| T1023 | Screening to determine the appropriateness of consideration of an individual for participation in a specified program, project or treatment protocol, per encounter | 3.0% | 1,200 | 1,176 | $40K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.1% | 868 | 833 | $29K |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 699 | 666 | $6K |
| 92551 | <1% | 787 | 776 | $5K | |
| 96127 | <1% | 1,570 | 1,504 | $2K |
22 more codes
| 90474 | <1% | 174 | $2K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 253 | $1K |
| 81002 | <1% | 468 | $1K | |
| 85018 | <1% | 1,040 | $1K | |
| 99173 | <1% | 480 | $806.66 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 208 | $539.96 |
| 83655 | <1% | 83 | $397.49 | |
| 90670 | <1% | 942 | $230.14 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | <1% | 76 | $32.31 |
| 90686 | <1% | 2,877 | $23.19 | |
| 90633 | 0% | 675 | $0.00 | |
| 90685 | 0% | 102 | $0.00 | |
| 3725F | 0% | 785 | $0.00 | |
| 90681 | 0% | 78 | $0.00 | |
| 90734 | 0% | 68 | $0.00 | |
| 90698 | 0% | 1,011 | $0.00 | |
| 90651 | 0% | 154 | $0.00 | |
| 90680 | 0% | 111 | $0.00 | |
| 90744 | 0% | 54 | $0.00 | |
| G0180 | Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and allowed practitioners to affirm the initial implementation of the plan of care | 0% | 49 | $0.00 |
| 90688 | 0% | 16 | $0.00 | |
| 90733 | 0% | 12 | $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 officialPIGEON, MARY (CREDENTIALING SPECIALIST)
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.