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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMainehealth
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    Mainehealth — Billing Profile & Reimbursement Data

    NPI 1376981993 · Portland, ME · Surgery Physician

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    Mainehealth is a surgery physician provider located in Portland, 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMainehealth
    Address887 Congress St
    CityPortland
    StateME
    ZIP04102
    TaxonomySurgery Physician
    NPI EnumeratedJune 5, 2013

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

    Payer SourceTotal Paid
    Medicaid$1.5M
    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.

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient33,500$40$1.5M
    93880Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…470$60$26K
    11102The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.290$50$13.2K
    93922Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral1,250$10$7.5K
    93926The provider performs a duplex ultrasound scan of the lower extremity arteries or bypass grafts. Providers perform noninvasive arterial diagnostic procedures to examine the rate of blood flow and to…120$40$4.4K
    76536The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.380$10$4.2K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.810$10$4K
    17110The provider destroys benign lesions using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of one to 14 lesions other than skin tags or…170$20$3.1K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…1,010$1$3K
    88305The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…1,280$1$2.5K

    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.

    Full comparison — all codes billed, vs. Maine median

    15 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient206018,740$60$4.6M
    88305The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…30502,110$20$123K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.446012,710$1$57.8K
    93880Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…610490$60$41K
    96372A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…8190400$10$32.8K
    Q3014Telehealth originating site facility fee4760360$10$31.2K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…47804,330$1$30.3K
    11102The provider biopsies a single skin lesion using a tangential (side–ways) approach; he shaves off the lesion or scoops it out with a knife or curette.710300$50$22.3K
    93923Noninvasive arterial diagnostic procedures are performed to examine the rate of blood flow in an area and to assess the presence of a blockage in the upper and lower extremity arteries.…61060$40$16.8K
    76536The provider performs real–time ultrasound examination of the soft tissues of the head and neck and records and saves the images for later review.93070$40$16K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    MainehealthMEGeneral Acute Care Hospital$0$142.6M
    MainehealthMECommunity/Behavioral Health Agency$0$115M
    MainehealthMEGeneral Acute Care Hospital$0$70.7M
    MainehealthMEGeneral Acute Care Hospital$0$40M
    MainehealthMEGeneral Acute Care Hospital$0$31.5M
    MainehealthMEGeneral Acute Care Hospital$0$22.7M
    MainehealthMERural Health Clinic/Center$0$16.7M
    MainehealthMEMulti-Specialty Clinic/Center$0$10.9M
    MainehealthMERural Health Clinic/Center$0$10M
    MainehealthMERural Health Clinic/Center$0$9.8M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Shalom House, Inc.MEMental Illness Community Based Residential Treatment Facility$0$81.9M
    Mercy HospitalMEGeneral Acute Care Hospital$0$35.5M
    Maxim Healthcare Services, Inc.MEHome Health Agency$0$28.1M
    Quality Care Access, LLCMEIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$17.2M
    Portland Community Health CenterMEFederally Qualified Health Center (FQHC)$0$12.9M
    Al-shawk Home Healthcare, LLCMEPersonal Care Attendant$0$7M
    Maine Eye Center, PAMEOphthalmology Physician$0$6.1M
    Hand Of Mercy Health Care, LLCMEMental Health Clinic/Center (Including Community Mental Health Center)$0$6.1M
    MainehealthMEGeneral Acute Care Hospital$0$5.5M
    Merrimack River Medical Services, Inc.MESubstance Use Disorder Rehabilitation Clinic/Center$253.7K$4.6M

    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 6 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Maine Distribution
    Mainehealth — 1 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maine