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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMainehealth
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    Mainehealth — Billing Profile & Reimbursement Data

    NPI 1063726891 · Portland, ME · Maternal & Fetal Medicine Physician

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    Mainehealth is a maternal & fetal medicine physician provider located in Portland, Maine. This profile covers 0 Medicare and 38 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMainehealth
    Address887 Congress St
    CityPortland
    StateME
    ZIP04102
    TaxonomyMaternal & Fetal Medicine Physician
    NPI EnumeratedAugust 4, 2010

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$4.1M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    38 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    76819The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.14,560$100$1.4M
    G0463Hospital outpatient clinic visit for assessment and management of a patient11,660$90$1.1M
    76811The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…2,770$170$476.4K
    76805In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…3,220$90$290.2K
    76816The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.10,680$20$224.4K
    76825The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.520$400$206.6K
    76817The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.4,220$40$168.8K
    76801In this procedure, the provider performs a real time or live image, ultrasound of a pregnant uterus for examination of the first or a single fetus and mother during the first trimester, or less than…990$90$87.9K
    76830The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.720$80$58.2K
    76815The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.7,200$10$36K

    Showing 1–10 of 38

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Maine median

    38 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient346018,740$60$4.6M
    76819The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.330410$50$232.4K
    76811The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…210420$120$152.8K
    88305The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…47502,110$20$123K
    76825The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.11090$370$67.1K
    76816The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.330640$20$65.2K
    76805In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…330280$60$51K
    76830The provider performs a transvaginal ultrasound to assess the reproductive organs, that is, the uterus, fallopian tubes, ovaries, cervix, and vagina in a female patient.1850400$60$45.2K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.140190390$20$42.6K
    76817The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.330280$30$41.9K

    Showing 1–10 of 38

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    MainehealthMEGeneral Acute Care Hospital$0$142.6M
    MainehealthMECommunity/Behavioral Health Agency$0$115M
    MainehealthMEGeneral Acute Care Hospital$0$70.7M
    MainehealthMEGeneral Acute Care Hospital$0$40M
    MainehealthMEGeneral Acute Care Hospital$0$31.5M
    MainehealthMEGeneral Acute Care Hospital$0$22.7M
    MainehealthMERural Health Clinic/Center$0$16.7M
    MainehealthMEMulti-Specialty Clinic/Center$0$10.9M
    MainehealthMERural Health Clinic/Center$0$10M
    MainehealthMERural Health Clinic/Center$0$9.8M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Shalom House, Inc.MEMental Illness Community Based Residential Treatment Facility$0$81.9M
    Mercy HospitalMEGeneral Acute Care Hospital$0$35.5M
    Maxim Healthcare Services, Inc.MEHome Health Agency$0$28.1M
    Quality Care Access, LLCMEIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$17.2M
    Portland Community Health CenterMEFederally Qualified Health Center (FQHC)$0$12.9M
    Al-shawk Home Healthcare, LLCMEPersonal Care Attendant$0$7M
    Maine Eye Center, PAMEOphthalmology Physician$0$6.1M
    Hand Of Mercy Health Care, LLCMEMental Health Clinic/Center (Including Community Mental Health Center)$0$6.1M
    MainehealthMEGeneral Acute Care Hospital$0$5.5M
    Merrimack River Medical Services, Inc.MESubstance Use Disorder Rehabilitation Clinic/Center$253.7K$4.6M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Maine Providers
    0 of 6 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Maine Distribution
    Mainehealth — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maine