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.

York Hospital (NPI 1376528398)

Field	Value
Entity Type	Organization
Organization	York Hospital
Address	15 Hospital Dr
City	York
State	ME
ZIP	03909
Taxonomy	General Acute Care Hospital
NPI Enumerated	December 13, 2005

Payer Source	Total Paid
Medicaid	$5.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

287 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…	47,600	$40	$1.7M
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…	20,840	$40	$854.2K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	77,540	$10	$697.9K
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…	4,530	$50	$240K
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.	4,730	$50	$236.6K
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.	5,130	$40	$189.7K
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.	5,680	$30	$153.4K
Q3014	Telehealth originating site facility fee	16,100	$10	$128.8K
J0585	Injection, onabotulinumtoxina, 1 unit	1,730	$70	$119.5K
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…	1,560	$60	$86K

Showing 1–10 of 287

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

York Hospital — 2 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

287 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	14	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.	35	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.	28	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.	33	50	11,590	$60	$942.4K
J0585	Injection, onabotulinumtoxina, 1 unit	6	20	1,240	$380	$618.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	26	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.	34	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…	10	30	880	$110	$338.4K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	28	30	200	$250	$316.8K
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.	33	40	5,020	$40	$302.3K

Showing 1–10 of 287

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Columbus Radiology Corp	OH	Diagnostic Radiology Physician	$0	$49.9M
York Hospital	PA	General Acute Care Hospital	$0	$40.7M
Wellspan Medical Group	PA	Psychiatry Physician	$0	$22.3M
Wellspan Medical Group	PA	Pediatrics Physician	$0	$9.9M
York Hospital	PA	Family Medicine Physician	$0	$6.2M
George Gentchos	NJ	Diagnostic Radiology Physician	$335.4K	$0
Brian Keroack	ME	Specialist	$326.6K	$0
Edward Fels	ME	Specialist	$266.6K	$0
Peter Dourdoufis	NH	Cardiovascular Disease Physician	$254.4K	$0
Jeffrey Colnes	ME	Cardiovascular Disease Physician	$226K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
York Ambulance Association, Inc.	ME	Land Ambulance	$288K	$242.7K
Joan Sisto	ME	Dermatology Physician	$420.7K	$0
Denture Crafters LLC.	ME	Denturist	$0	$354.4K
Ashley Mace	ME	Nurse Practitioner	$133.9K	$0
David Cunningham	ME	Clinical Cardiac Electrophysiology Physician	$132.9K	$0
Judith Fisher	ME	Dermatology Physician	$116.1K	$0
Jennifer Cutts	ME	Diagnostic Radiology Physician	$115.2K	$0
Stephen Morley	ME	Psychiatric/Mental Health Nurse Practitioner	$16K	$97.9K
Kira Wendorf	ME	Diagnostic Radiology Physician	$113.1K	$0
Nicholas Armellino	ME	Emergency Medicine Physician	$108.6K	$0

York Hospital — Billing Profile & Reimbursement Data

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York 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

Related Providers

Nearby Providers

Frequently Asked Questions

References