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.

Penobscot Valley Hospital (NPI 1093716086)

Penobscot Valley Hospital is a critical access hospital provider located in Lincoln, Maine. This profile covers 0 Medicare and 118 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	Penobscot Valley Hospital
Address	7 Transalpine Rd
City	Lincoln
State	ME
ZIP	04457
Taxonomy	Critical Access Hospital
NPI Enumerated	August 2, 2005

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

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

118 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,350	$210	$277.6K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	15,090	$20	$226.3K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	3,890	$30	$120.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	17,080	$10	$119.5K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	1,540	$80	$118.7K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	3,700	$20	$55.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	10,820	$1	$43.3K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	4,820	$10	$38.5K
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.	13,080	$1	$26.2K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	180	$110	$19.4K

Showing 1–10 of 118

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

Penobscot Valley Hospital — 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

118 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	24	60	9,550	$100	$1.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	31	60	4,690	$180	$1.5M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	19	50	11,590	$60	$942.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	33	30	6,230	$70	$515.4K
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	39	60	2,380	$90	$345.7K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	18	40	5,020	$40	$302.3K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	35	40	3,970	$60	$299.5K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	35	40	1,830	$90	$292.9K
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…	219	460	1,240	$30	$190K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	36	50	2,560	$40	$174.3K

Showing 1–10 of 118

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Penobscot Valley Hospital	ME	Rural Health Clinic/Center	$0	$1M
Alaa Ayyoub	WA	Interventional Cardiology Physician	$57.6K	$0
Daniel Stanhiser	ME	Family Medicine Physician	$56.5K	$0
Anas Mansour	ME	Cardiovascular Disease Physician	$55.8K	$0
Mohamed Shokr	ME	Clinical Cardiac Electrophysiology Physician	$54.6K	$0
Brian Berberian	ME	Gastroenterology Physician	$51.2K	$0
Thomas Earl	ME	Interventional Cardiology Physician	$50K	$0
Spyridon Akrivakis	ME	Clinical Cardiac Electrophysiology Physician	$49.8K	$0
Sreedhar Reddy Madireddy	NC	Cardiovascular Disease Physician	$49.3K	$0
Juan Merchan Hakspiel	ME	Clinical Cardiac Electrophysiology Physician	$48K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
R & C Home Care, Inc.	ME	In Home Supportive Care Agency	$0	$13.5M
Health Access Network Inc	ME	Federally Qualified Health Center (FQHC)	$0	$11.7M
Mc Community Services	ME	Community/Behavioral Health Agency	$0	$8.1M
Turning Point Mental Health Professionals LLC	ME	Counselor	$0	$2.2M
Health Access Network, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$1.6M
Total Renal Care Inc	ME	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$816.2K
Town Of Lincoln	ME	Ambulance	$126K	$492.8K
Devesh Agarwal	ME	Family Medicine Physician	$79.8K	$0
Gary Degen	ME	Foot & Ankle Surgery Podiatrist	$27.9K	$0
Tammy Webb	ME	Physician Assistant	$16.7K	$0

Penobscot Valley Hospital — Billing Profile & Reimbursement Data

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Penobscot Valley Hospital — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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