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 Maine for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Maine 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. Maine (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.

Sebasticook Family Doctors (NPI 1023621273)

Field	Value
Entity Type	Organization
Organization	Sebasticook Family Doctors
Address	291 Williams Road
City	Newport
State	ME
ZIP	04953
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 27, 2020

Payer Source	Total Paid
Medicaid	$394.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	1,250	$270	$335.2K
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…	260	$130	$33.4K
D0274	N/A	120	$100	$11.7K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	70	$70	$4.9K
D0150	Comprehensive oral evaluation – new or established patient	40	$120	$4.8K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	20	$80	$1.4K
92551	The provider delivers a limited series of tones or sounds to a patient to determine if the patient’s hearing is in an acceptable range to detect hearing problems.	70	$20	$1.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	30	$30	$890
G0008	Administration of influenza virus vaccine	70	$10	$760
99173	The provider checks the eyesight in both eyes of a pediatric patient by asking him to read letters of varying sizes on a standard chart, such as a Snellen’s chart, which he keeps 20 feet away from…	30	$1	$120

Showing 1–10 of 18

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maine Distribution

Sebasticook Family Doctors — 0 of 10 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

18 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	138	180	8,540	$180	$3M
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…	330	480	1,030	$20	$128.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	78	80	540	$40	$61.6K
D1120	Prophylaxis–child	121	160	500	$30	$56.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	125	130	760	$20	$46.4K
D0150	Comprehensive oral evaluation – new or established patient	83	100	310	$50	$39.3K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	120	160	300	$40	$34.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	66	90	150	$40	$31.9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	120	190	470	$10	$31.8K
D0274	N/A	61	110	210	$20	$18.9K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sebasticook Family Doctors, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$7.4M
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$4.3M
Ian Jones	ME	Optometrist	$80K	$0
Steven Badeen	ME	Family Medicine Physician	$65.3K	$0
Rebecca Beckwith	ME	Clinical Social Worker	$5.5K	$0

Nearby Providers

Other providers in the same ZIP code as Sebasticook Family Doctors, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebasticook Valley Health	ME	Rural Health Clinic/Center	$0	$1.3M
Newport Family Practice PA	ME	Family Medicine Physician	$0	$873.4K
Maine Assistive Technology Solutions	ME	Occupational Therapy Assistant	$0	$713.4K
Jones Eye Associates, PA	ME	Corneal and Contact Management Optometrist	$0	$678.5K
Town Of Newport	ME	Land Ambulance	$51.6K	$117.9K
Kiran Jones	ME	Optometrist	$34.4K	$0

Sebasticook Family Doctors — Billing Profile & Reimbursement Data

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Sebasticook Family Doctors — 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