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.

Life By Design, PA (NPI 1053345918)

Field	Value
Entity Type	Organization
Organization	Life By Design, PA
Address	147 Academy St
City	Presque Isle
State	ME
ZIP	04769
Taxonomy	Clinical Social Worker
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$9.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
H2015	Comprehensive community support services, per 15 minutes	62,650	$90	$5.8M
H0004	Behavioral health counseling and therapy, per 15 minutes	29,780	$80	$2.4M
T1017	Targeted case management, each 15 minutes	19,150	$80	$1.6M
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	6,130	$20	$140.9K

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

Life By Design, PA — 2 of 4 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

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2015	Comprehensive community support services, per 15 minutes	4	70	7,120	$100	$1.7M
T1017	Targeted case management, each 15 minutes	26	100	4,690	$90	$1M
H0004	Behavioral health counseling and therapy, per 15 minutes	19	290	860	$80	$805.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	5	140	470	$30	$59K

Nearby Providers

Other providers in the same ZIP code as Life By Design, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Aroostook Mental Health Services, Inc.	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$53.2M
The Aroostook Medical Center	ME	General Acute Care Hospital	$0	$38.5M
Central Aroostook Association	ME	Local Education Agency (LEA)	$0	$36.5M
Personal Services Of Aroostook	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$10.7M
Aroostook Agency On Aging	ME	In Home Supportive Care Agency	$0	$7.9M
Discovery House Wc, Inc.	ME	Methadone Clinic	$0	$4M
Pines Health Services	ME	Federally Qualified Health Center (FQHC)	$0	$3.7M
Northern Maine Oral & Facial Surgery PA	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$3.5M
Dunrovin Enterprises, Inc.	ME	In Home Supportive Care Agency	$0	$3.1M
Aroostook Dental Clinic, Inc.	ME	Dental Clinic/Center	$0	$2.7M

Life By Design, PA — Billing Profile & Reimbursement Data

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Life By Design, PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References