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 1063464634)

Sebasticook Family Doctors is a federally qualified health center (fqhc) provider located in Newport, Maine. This profile covers 0 Medicare and 41 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	Sebasticook Family Doctors
Address	118 Moosehead Trl
City	Newport
State	ME
ZIP	04953
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	May 16, 2006

Payer Source	Total Paid
Medicaid	$7.4M
Medicare	$0

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

41 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	34,050	$180	$6M
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…	15,710	$30	$439.8K
G0467	Federally 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…	4,750	$60	$280.4K
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…	7,080	$30	$205.3K
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,…	4,690	$30	$131.3K
90832	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…	3,640	$30	$98.4K
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…	2,780	$30	$80.6K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	920	$40	$36.8K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,010	$30	$33.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,520	$10	$16.7K

Showing 1–10 of 41

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 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

41 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	25	180	8,540	$180	$3M
G0467	Federally 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…	27	80	3,000	$50	$269.8K
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…	83	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…	55	480	1,030	$20	$128.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	34	40	330	$20	$124.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	46	70	1,060	$40	$97K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	27	30	640	$60	$96.3K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	54	70	1,000	$40	$91K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	24	50	110	$60	$72.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	126	170	380	$50	$63.7K

Showing 1–10 of 41

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$4.3M
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$394.3K
Ian Jones	ME	Optometrist	$80K	$0
Steven Badeen	ME	Family Medicine Physician	$65.3K	$0
Rebecca Beckwith	ME	Clinical Social Worker	$5.5K	$0