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.

Maine Nephrology Associates P.A. (NPI 1043424344)

Maine Nephrology Associates P.A. is a nephrology physician provider located in Portland, Maine. This profile covers 0 Medicare and 27 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Maine Nephrology Associates P.A.
Address	1600b Congress St
City	Portland
State	ME
ZIP	04102
Taxonomy	Nephrology Physician
NPI Enumerated	May 9, 2007

Payer Source	Total Paid
Medicaid	$448.6K
Medicare	$0

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	3,260	$70	$227.9K
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…	2,720	$40	$106K
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…	1,910	$30	$47.7K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	1,000	$30	$27.1K
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…	250	$30	$7.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	140	$50	$6.1K
90966	The provider manages all the physician related services for one full month for the home dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal disease,…	60	$70	$3.9K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	60	$60	$3.6K
80069	The lab analyst performs a renal function panel test in which he measures the blood level of certain chemicals the descriptor lists to evaluate how well the kidney is functioning.	1,150	$1	$3.5K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	3,440	$1	$3.4K

Showing 1–10 of 27

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

Maine Nephrology Associates P.A. — 0 of 25 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	4	10	3,260	$70	$211.4K
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…	165	460	1,240	$30	$190K
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…	332	480	1,030	$20	$128.9K
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…	26	70	730	$30	$120.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	34	50	480	$40	$89.9K
36902	The provider introduces a needle and/or catheter under fluoroscopic guidance (live X–rays that can be viewed on a monitor) and injects contrast material into the dialysis access point to visualize…	2	10	30	$610	$73.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	52	60	12,710	$1	$57.8K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	40	50	3,090	$10	$45.8K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	2	10	160	$30	$39.1K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	5	10	170	$60	$32K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Shalom House, Inc.	ME	Mental Illness Community Based Residential Treatment Facility	$0	$81.9M
Mercy Hospital	ME	General Acute Care Hospital	$0	$35.5M
Maxim Healthcare Services, Inc.	ME	Home Health Agency	$0	$28.1M
Quality Care Access, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$17.2M
Portland Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$12.9M
Al-shawk Home Healthcare, LLC	ME	Personal Care Attendant	$0	$7M
Maine Eye Center, PA	ME	Ophthalmology Physician	$0	$6.1M
Hand Of Mercy Health Care, LLC	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$6.1M
Mainehealth	ME	General Acute Care Hospital	$0	$5.5M

Maine Nephrology Associates P.A. — Billing Profile & Reimbursement Data

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Maine Nephrology Associates P.A. — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Michael Akom	ME	Nephrology Physician	$102.5K	$0
Gary Diperna	ME	Nephrology Physician	$87.4K	$0
Patricia Cantlin	ME	Nephrology Physician	$77K	$0
Ioan Cosma	ME	Nephrology Physician	$56.2K	$0
Paul Parker	ME	Nephrology Physician	$45K	$0
John Vella	ME	Nephrology Physician	$16K	$0