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.

Ohi (NPI 1427121243)

Field	Value
Entity Type	Organization
Organization	Ohi
Address	203 Maine Ave
City	Bangor
State	ME
ZIP	04401
Taxonomy	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
NPI Enumerated	November 17, 2006

Payer Source	Total Paid
Medicaid	$61.9M
Medicare	$0

Key Findings

OHI is effectively a Medicaid-only billing entity: there is no Medicare billing on file (none), and the provider reports $61.9M in lifetime Medicaid revenue, indicating Medicaid is the sole material payer supporting its operations. This single-payer profile suggests financial performance and exposure are tightly coupled to Medicaid policy and waiver program stability in Maine.

Revenue is extremely concentrated in a single service line: the precomputed top-3 Medicaid codes account for 100.0% of this provider's total Medicaid revenue, with T2016 alone generating $61.9M and representing 99.9% of Medicaid revenue. That concentration indicates that virtually all billing is tied to the residential habilitation, waiver per diem represented by T2016.

Service-line implications from code mix: T2016 (Habilitation, residential, waiver; per diem) dominance aligns with the provider taxonomy (Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility), indicating the operation is primarily residential habilitation under Medicaid waivers. Smaller volumes of T2025 (Waiver services; nos) and G9007 (Coordinated care fee, scheduled team conference) suggest occasional use of general waiver billing and modest coordination fees, but these are immaterial to overall revenue.

Competitive standing for the primary code is modest within the state: for T2016 this provider ranks #14 of 75 providers in-state (82th percentile) and the dataset labels its volume as typical/unremarkable. This rank indicates the provider is a routine, not dominant, participant in residential habilitation services statewide despite its reliance on that service line for nearly all revenue.

The two supplementary codes are negligible revenue contributors and do not alter the business profile: T2025 accounts for $63.2K (0.1% of Medicaid revenue) across 13 claims with a $4862 avg paid/claim and ranks #2 of 2 providers in-state (0th percentile), while G9007 accounts for $10.6K (0.0% of Medicaid revenue) across 304 claims with a $35 avg paid/claim and ranks #18 of 25 providers in-state (29th percentile). Both are described as typical, unremarkable volume items and do not diversify the provider's revenue base.

Concentration risk is material: reliance on a single per-diem waiver code (T2016 at $2560 avg paid/claim over 24.2K claims) means payment-rate or eligibility changes to that code or the underlying waiver program could substantially affect OHI’s financials. The provider’s lack of Medicare exposure (none) eliminates any offsetting payer diversification.

Organizational tenure supports an established footprint: OHI’s NPI was enumerated on 2006-11-17 (~20 years ago), indicating long-standing participation in state Medicaid waiver networks and a sustained operational presence in Maine. This longevity, combined with the code mix, suggests an entrenched residential habilitation operation rather than a new or experimental service model.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2016	Habilitation, residential, waiver; per diem	24,160	$2,560	$61.9M
T2025	Waiver services; not otherwise specified (nos)	10	$4,860	$63.2K
G9007	Coordinated care fee, scheduled team conference	300	$40	$10.6K

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

Ohi — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2016	Habilitation, residential, waiver; per diem	14	80	7,300	$1,670	$30.8M
G9007	Coordinated care fee, scheduled team conference	18	30	950	$60	$258.2K
T2025	Waiver services; not otherwise specified (nos)	2	10	20	$4,830	$72.5K

Nearby Providers

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

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	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
Lifeflight Of Maine, LLC	ME	Air Ambulance	$2.4M	$19.8M

Ohi — Billing Profile & Reimbursement Data

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Ohi — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References