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.

Mainehealth (NPI 1245873082)

Field	Value
Entity Type	Organization
Organization	Mainehealth
Address	181 Franklin Health Commons
City	Farmington
State	ME
ZIP	04938
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	October 24, 2019

Payer Source	Total Paid
Medicaid	$16.7M
Medicare	$0

Medicaid: Complete Services Breakdown

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

97 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	67,960	$220	$15.1M
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…	29,240	$20	$584.7K
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…	24,930	$20	$448.7K
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…	2,560	$30	$64K
G0008	Administration of influenza virus vaccine	4,160	$10	$58.2K
99203	The provider sees a new 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 provider…	2,860	$20	$57.3K
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,…	2,880	$20	$54.7K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	740	$70	$53.6K
99204	The provider sees a new 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 provider…	2,240	$20	$44.7K
G0009	Administration of pneumococcal vaccine	2,200	$10	$26.4K

Showing 1–10 of 97

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

Mainehealth — 1 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

97 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	12	180	8,540	$180	$3M
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…	24	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…	32	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…	39	40	330	$20	$124.1K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	16	40	860	$70	$109.1K
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…	16	70	1,060	$40	$97K
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…	15	70	1,000	$40	$91K
90847	A provider meets with the patient’s family with the patient present to counsel the family on the psychological issues affecting the patient and the family. The provider supplies psychotherapy to the…	25	30	240	$60	$74.9K
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…	33	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…	22	170	380	$50	$63.7K

Showing 1–10 of 97

Related Providers

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

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	Multi-Specialty Clinic/Center	$0	$10.9M
Mainehealth	ME	Rural Health Clinic/Center	$0	$10M
Mainehealth	ME	Rural Health Clinic/Center	$0	$9.8M
Mainehealth	ME	Rural Health Clinic/Center	$0	$9.6M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Work First, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$7.2M
Mainehealth	ME	Rural Health Clinic/Center	$0	$2.4M
R.s.u. #9	ME	Local Education Agency (LEA)	$0	$2.3M
Mainehealth	ME	General Acute Care Hospital	$0	$1.4M
Wilson Stream Family Practice LLC PA	ME	Family Medicine Physician	$0	$1.2M
Farmington Oral & Facial Surgery P A	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$1.2M
Troy A Norton Od, Inc.	ME	Optometrist	$0	$481.5K
Mainehealth	ME	Critical Access Hospital	$0	$433.3K
Maine Growth Opportunities, Inc.	ME	Specialist	$0	$351.7K
Scott Weiner	ME	Orthopaedic Surgery Physician	$82.3K	$0

Mainehealth — Billing Profile & Reimbursement Data

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Mainehealth — 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