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.

Sebasticook Valley Health (NPI 1427181486)

Field	Value
Entity Type	Organization
Organization	Sebasticook Valley Health
Address	80 Main Street
City	Unity
State	ME
ZIP	04988
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	March 13, 2007

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	11,460	$110	$1.3M
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…	6,760	$10	$67.6K
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…	4,680	$10	$28.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	430	$1	$1.7K
99215	The provider sees an established 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…	150	$10	$1.5K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	140	$10	$1.1K
80053	The 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.	30	$30	$920
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	90	$10	$910
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	50	$20	$860
G0463	Hospital outpatient clinic visit for assessment and management of a patient	400	$1	$790

Showing 1–10 of 20

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

Sebasticook Valley Health — 0 of 15 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

20 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	49	60	18,740	$60	$4.6M
T1015	Clinic visit/encounter, all-inclusive	75	180	8,540	$180	$3M
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…	88	460	1,240	$30	$190K
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…	135	480	1,030	$20	$128.9K
99215	The provider sees an established 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…	105	170	380	$50	$63.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	137	140	470	$30	$59K
80053	The 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.	60	60	12,710	$1	$57.8K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	58	70	220	$70	$54K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	123	140	670	$20	$48.8K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	56	60	6,050	$10	$47.4K

Showing 1–10 of 20

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Maine Healthcare Systems Inland Hospital	ME	General Acute Care Hospital	$0	$18.3M
Sebasticook Valley Health	ME	Critical Access Hospital	$0	$3.6M
Sebasticook Valley Health	ME	Rural Health Clinic/Center	$0	$2.8M
Sebasticook Valley Health	ME	Rural Health Clinic/Center	$0	$1.3M
Sathish Kumar Cullath Harikrishnan	IL	Hospitalist Physician	$153.6K	$200.1K
Gabriel Thornton	GA	Critical Care Medicine (Internal Medicine) Physician	$241.4K	$0
Matthew Moore	NH	Diagnostic Radiology Physician	$117.7K	$740
Sayeedul Hasan	ME	Internal Medicine Physician	$108.5K	$0
Ajit Chary	IL	Pulmonary Disease Physician	$101.4K	$0
Jerald Kuhn	ME	Diagnostic Radiology Physician	$97.5K	$0

Sebasticook Valley Health — Billing Profile & Reimbursement Data

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Sebasticook Valley Health — 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

Frequently Asked Questions

References