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.

Northeast Nephrology PA (NPI 1336145200)

Northeast Nephrology PA is a nephrology physician provider located in Bangor, Maine. This profile covers 0 Medicare and 15 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	Northeast Nephrology PA
Address	417 State St
City	Bangor
State	ME
ZIP	04401
Taxonomy	Nephrology Physician
NPI Enumerated	June 24, 2005

Payer Source	Total Paid
Medicaid	$1.1M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	6,030	$80	$476.3K
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…	7,050	$40	$246.8K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	5,920	$30	$159.8K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	1,920	$70	$126.9K
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…	2,550	$40	$89.3K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	50	$50	$2.7K
99205	The provider sees a new 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 provider…	20	$50	$830
90966	The provider manages all the physician related services for one full month for the home dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal disease,…	10	$60	$770
4040F	Pneumococcal vaccine triggers the immune response of the patient and protects against infection from pneumococcus bacteria, an infectious organism. The provider administers the vaccine to all…	30	$0	$0
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	20	$0	$0

Showing 1–10 of 15

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

Northeast Nephrology PA — 3 of 8 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	1	10	3,260	$70	$211.4K
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…	172	460	1,240	$30	$190K
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…	10	70	730	$30	$120.2K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	1	10	160	$30	$39.1K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	1	10	170	$60	$32K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	23	40	70	$60	$16.6K
99205	The provider sees a new 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 provider…	39	60	40	$80	$15.4K
90966	The provider manages all the physician related services for one full month for the home dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal disease,…	3	10	60	$60	$3.5K
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	6	10	450	$1	$10
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	15	40	190	$1	$1

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Maine Medical Center	ME	General Acute Care Hospital	$0	$159.3M
Creative Options, LLC	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$78.7M
Mas Medical Staffing Corporation	ME	Community/Behavioral Health Agency	$0	$62.5M
Ohi	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$61.9M
Ohi	ME	Mental Illness Community Based Residential Treatment Facility	$0	$39.6M
St. Joseph Hospital	ME	General Acute Care Hospital	$0	$38.8M
Mert Enterprises, Inc.	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$36.3M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$27.3M
Amicus	ME	Developmentally Disabled Services Day Training Agency	$0	$26.1M
Branches, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$25.4M

Northeast Nephrology PA — Billing Profile & Reimbursement Data

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Northeast Nephrology PA — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Stephen Comeau	ME	Nephrology Physician	$239.8K	$0
Manish Nepal	ME	Nephrology Physician	$104.3K	$0
Mihail Soare	ME	Nephrology Physician	$104.2K	$0
Hui Liu	ME	Nephrology Physician	$101.7K	$0
Michael Mcgoldrick	ME	Nephrology Physician	$99.4K	$0
Amanda Theriault	ME	Adult Health Nurse Practitioner	$9.9K	$0