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.

Rumford Hospital (NPI 1205991122)

Rumford Hospital is a critical access hospital provider located in Rumford, Maine. This profile covers 0 Medicare and 219 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	Rumford Hospital
Address	420 Franklin St
City	Rumford
State	ME
ZIP	04276
Taxonomy	Critical Access Hospital
NPI Enumerated	December 22, 2006

Payer Source	Total Paid
Medicaid	$2.4M
Medicare	$0

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

219 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	11,550	$30	$369.5K
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.	25,600	$10	$281.6K
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.	28,640	$10	$200.5K
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.	2,750	$60	$159.3K
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.	3,930	$30	$98.2K
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.	1,910	$50	$97.2K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	4,260	$20	$89.5K
96375	Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…	6,220	$10	$74.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	6,610	$10	$72.7K
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…	9,070	$10	$63.5K

Showing 1–10 of 219

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

Rumford 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

219 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	55	60	18,740	$60	$4.6M
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.	14	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.	14	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.	9	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.	16	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.	26	60	2,380	$90	$345.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	19	30	880	$110	$338.4K
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.	11	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.	21	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…	37	40	1,830	$90	$292.9K

Showing 1–10 of 219

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Daniel Rausch	ME	Hematology & Oncology Physician	$541K	$0
Julia Moukharskaya	ME	Hematology & Oncology Physician	$519.1K	$0
Andrei Zaslavsky	ME	Internal Medicine Physician	$187.1K	$0
Julie Suarez	NH	Internal Medicine Physician	$175.2K	$0
Danielle Pineda	NJ	Vascular Surgery Physician	$174.3K	$0
Jared Tobolski	ME	Cardiovascular Disease Physician	$155.7K	$0
Thomas Scott	NH	Emergency Medicine Physician	$142.1K	$0
Cason Quinn	ME	Foot & Ankle Surgery Podiatrist	$129.4K	$0
Eric Benson	ME	Orthopaedic Surgery Physician	$121.6K	$0
Amr Elmaghraby	FL	Neurology Physician	$114K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hope Association	ME	Developmentally Disabled Services Day Training Agency	$0	$10.2M
Rumford Community Family Health Center, Inc.	ME	Rural Health Clinic/Center	$0	$6.7M
Community Concepts Incorporated	ME	Community/Behavioral Health Agency	$0	$6.6M
Rumford Group Homes Inc	ME	Case Management Agency	$0	$2.3M
Lincare Inc.	ME	Durable Medical Equipment & Medical Supplies	$0	$2M
River Valley Counseling LLC	ME	Community/Behavioral Health Agency	$0	$779.2K
Discovery House Wc, Inc	ME	Methadone Clinic	$0	$576.5K
Mountain View Eyecare, P.A.	ME	Optometrist	$0	$442.3K

Rumford Hospital — Billing Profile & Reimbursement Data

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Rumford 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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