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.

Sebasticook Valley Health (NPI 1295367803)

Field	Value
Entity Type	Organization
Organization	Sebasticook Valley Health
Address	26 Main St Ste 2
City	Newport
State	ME
ZIP	04953
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	February 11, 2020

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	15,900	$80	$1.2M
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…	7,930	$10	$71.3K
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…	4,660	$10	$23.3K
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…	2,070	$10	$16.5K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	830	$10	$4.1K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	690	$10	$4.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	640	$1	$2.5K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	160	$10	$1.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	210	$1	$840
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	90	$10	$640

Showing 1–10 of 22

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

Sebasticook Valley Health — 0 of 14 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

22 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	56	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…	76	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…	136	480	1,030	$20	$128.9K
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…	67	70	1,060	$40	$97K
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…	26	170	380	$50	$63.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	70	140	470	$30	$59K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	19	70	220	$70	$54K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	57	80	90	$50	$53.3K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	106	140	670	$20	$48.8K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	66	130	760	$20	$46.4K

Showing 1–10 of 22

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebasticook Valley Health	ME	Critical Access Hospital	$0	$3.6M
Sebasticook Valley Health	ME	Rural Health Clinic/Center	$0	$2.8M
Sebasticook Valley Health	ME	Rural Health Clinic/Center	$0	$1.4M
Sathish Kumar Cullath Harikrishnan	IL	Hospitalist Physician	$153.6K	$200.1K
Gabriel Thornton	GA	Critical Care Medicine (Internal Medicine) Physician	$241.4K	$0
Matthew Moore	NH	Diagnostic Radiology Physician	$117.7K	$740
Ajit Chary	IL	Pulmonary Disease Physician	$101.4K	$0
Jerald Kuhn	ME	Diagnostic Radiology Physician	$97.5K	$0
Henry Talarico	ME	Diagnostic Radiology Physician	$82.7K	$0
David Langdon	ME	Diagnostic Radiology Physician	$81K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$7.4M
Newport Family Practice PA	ME	Family Medicine Physician	$0	$873.4K
Maine Assistive Technology Solutions	ME	Occupational Therapy Assistant	$0	$713.4K
Jones Eye Associates, PA	ME	Corneal and Contact Management Optometrist	$0	$678.5K
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$394.3K
Town Of Newport	ME	Land Ambulance	$51.6K	$117.9K
Ian Jones	ME	Optometrist	$80K	$0
Steven Badeen	ME	Family Medicine Physician	$65.3K	$0
Kiran Jones	ME	Optometrist	$34.4K	$0

Sebasticook Valley Health — Billing Profile & Reimbursement Data

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Sebasticook Valley Health — 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