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 1457461477)

Sebasticook Valley Health is a critical access hospital provider located in Pittsfield, Maine. This profile covers 0 Medicare and 271 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Sebasticook Valley Health
Address	447 N Main St
City	Pittsfield
State	ME
ZIP	04967
Taxonomy	Critical Access Hospital
NPI Enumerated	August 30, 2006

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

271 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	7,220	$50	$339.2K
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.	2,250	$120	$263K
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.	10,710	$20	$224.9K
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…	2,580	$80	$209.1K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,610	$70	$177.4K
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.	17,000	$10	$170K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,710	$90	$160.6K
G0378	Hospital observation service, per hour	1,550	$90	$141.2K
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…	27,160	$1	$108.6K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	7,450	$10	$96.9K

Showing 1–10 of 271

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 — 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

271 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	30	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.	23	60	4,690	$180	$1.5M
L4361	Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf	3	10	6,410	$220	$1.1M
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.	20	50	11,590	$60	$942.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	19	30	6,230	$70	$515.4K
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	3	10	400	$400	$476.5K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	29	100	670	$200	$363.5K
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.	31	60	2,380	$90	$345.7K
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.	26	30	200	$250	$316.8K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	32	100	660	$180	$316.3K

Showing 1–10 of 271

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebasticook Valley Health	ME	Rural Health Clinic/Center	$0	$2.8M
Sebasticook Valley Health	ME	Rural Health Clinic/Center	$0	$1.4M
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
Ajit Chary	IL	Pulmonary Disease Physician	$101.4K	$0
Jerald Kuhn	ME	Diagnostic Radiology Physician	$97.5K	$0
Henry Talarico	ME	Diagnostic Radiology Physician	$82.7K	$0
David Langdon	ME	Diagnostic Radiology Physician	$81K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cross Roads Case Management	ME	Case Management Agency	$0	$7.8M
Mohammad Shareef	ME	Family Medicine Physician	$82.9K	$0
Alexandra Idenburg	ME	General Practice Physician	$63.3K	$0
Michael Parks	ME	Optometrist	$62.1K	$0
Jeremy West	ME	Chiropractor	$6.6K	$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

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