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 Medical Partners (NPI 1104921535)

Maine Medical Partners is a obstetrics & gynecology physician provider located in Portland, Maine. This profile covers 0 Medicare and 30 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 Medical Partners
Address	887 Congress St
City	Portland
State	ME
ZIP	04102
Taxonomy	Obstetrics & Gynecology Physician
NPI Enumerated	September 13, 2006

Payer Source	Total Paid
Medicaid	$3M
Medicare	$0

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	22,840	$30	$776.6K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	28,270	$30	$706.8K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	16,890	$30	$455.9K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	15,170	$20	$303.3K
76811	The 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…	2,560	$60	$146K
76817	The provider performs an ultrasound of the pregnant uterus to examine the fetus and the mother's organs using a transvaginal approach.	5,750	$20	$132.2K
76805	In 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…	3,560	$30	$110.3K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	5,800	$20	$104.3K
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…	2,110	$40	$88.7K
76820	The provider performs Doppler ultrasonography for fetal surveillance to determine the velocity of blood flow through the umbilical artery. This test determines the timing of labor induction and when…	3,710	$20	$66.7K

Showing 1–10 of 30

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 Medical Partners — 8 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1013	Sign language or oral interpretive services, per 15 minutes	48	50	740	$90	$453.3K
76819	The provider performs a biophysical profile test to measure the health of the baby during pregnancy using only ultrasound and not a nonstress test.	2	30	410	$50	$232.4K
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…	317	460	1,240	$30	$190K
76811	The 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…	3	10	420	$120	$152.8K
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…	37	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…	24	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…	46	50	480	$40	$89.9K
76825	The provider performs real–time fetal echocardiography, with or without M–mode recording, for complete evaluation of a fetal cardiovascular system.	3	10	90	$370	$67.1K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2	30	640	$20	$65.2K
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…	161	170	380	$50	$63.7K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Mainehealth	ME	Community/Behavioral Health Agency	$0	$115M
Mainehealth	ME	General Acute Care Hospital	$0	$70.7M
Mainehealth	ME	General Acute Care Hospital	$0	$40M
Mainehealth	ME	General Acute Care Hospital	$0	$31.5M
Mainehealth	ME	General Acute Care Hospital	$0	$22.7M
Mainehealth	ME	Rural Health Clinic/Center	$0	$16.7M
Mainehealth	ME	Multi-Specialty Clinic/Center	$0	$10.9M
Mainehealth	ME	Rural Health Clinic/Center	$0	$10M
Mainehealth	ME	Rural Health Clinic/Center	$0	$9.8M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Merrimack River Medical Services, Inc.	ME	Substance Use Disorder Rehabilitation Clinic/Center	$253.7K	$4.6M

Maine Medical Partners — Billing Profile & Reimbursement Data

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Maine Medical Partners — 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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