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    OpenPayerNPI Medicare & MedicaidKatahdin Valley Health Center
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    Katahdin Valley Health Center — Billing Profile & Reimbursement Data

    NPI 1376618546 · Houlton, ME · Federally Qualified Health Center (FQHC)

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    Katahdin Valley Health Center is a federally qualified health center (fqhc) provider located in Houlton, Maine. This profile covers 0 Medicare and 95 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationKatahdin Valley Health Center
    Address59 Bangor St
    CityHoulton
    StateME
    ZIP04730
    TaxonomyFederally Qualified Health Center (FQHC)
    NPI EnumeratedNovember 22, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$22.5M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    95 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    T1015Clinic visit/encounter, all-inclusive95,210$210$20.3M
    G0467Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…18,520$70$1.3M
    G0470Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…3,820$120$473.1K
    99213The 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…49,670$1$149K
    G0511Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral…880$120$107.8K
    99214The 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…13,800$1$41.4K
    99212The 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,…17,270$1$34.5K
    98940The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in one to two spinal regions.9,320$1$18.6K
    99406The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.1,050$10$11.5K
    D1206Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients2,620$1$10.5K

    Showing 1–10 of 95

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Maine median

    95 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive51808,540$180$3M
    G0467Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…5803,000$50$269.8K
    D7140Extraction, erupted tooth or exposed root (elevation and/or forceps removal)3970630$100$235.5K
    99214The 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…514601,240$30$190K
    99213The 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…124801,030$20$128.9K
    99392Preventive 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…47701,060$40$97K
    G0470Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…630640$60$96.3K
    99391Preventive 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…65701,000$40$91K
    D2392Post 2 surface resin‑based composite6480260$80$88.2K
    D1351Sealant - per tooth74801,040$20$87.6K

    Showing 1–10 of 95

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    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Katahdin Valley Health CenterMEFederally Qualified Health Center (FQHC)$0$10M
    Katahdin Valley Health CenterMEFederally Qualified Health Center (FQHC)$0$8.7M
    Katahdin Valley Health CenterMEFederally Qualified Health Center (FQHC)$0$4.4M
    Katahdin Valley Health CenterMEFederally Qualified Health Center (FQHC)$0$2.1M
    Katahdin Valley Health CenterMEFederally Qualified Health Center (FQHC)$0$2M
    Katahdin Valley Health CenterMEFederally Qualified Health Center (FQHC)$0$1.5M
    Philip McdonaldFLDiagnostic Radiology Physician$444.3K$42.8K
    Abbas ChamsuddinILDiagnostic Radiology Physician$368.8K$114.2K
    Elliott WagnerCADiagnostic Radiology Physician$392.6K$7.3K
    Lisa VinalORFamily Nurse Practitioner$69.5K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Community Living AssociationMENursing Care Agency$0$30.4M
    Houlton Regional HospitalMERural Health Clinic/Center$0$7M
    Houlton Band Of Maliseet IndiansMEClinic/Center$0$4.3M
    Houlton Regional HospitalMECritical Access Hospital$0$4.1M
    A New Start LLCMESocial Worker$0$3.5M
    Houlton Regional HospitalMERural Health Clinic/Center$0$3.1M
    Town Of HoultonMELand Ambulance$243.2K$1.6M
    Abc Behave LLCMEDevelopmental Therapist$0$1.4M
    Southern Aroostook Ems AuthorityMELand Ambulance$126.7K$343.9K
    Simon OuaknineMEUrology Physician$129.2K$120

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Maine Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Maine Distribution
    Katahdin Valley Health Center — 5 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maine