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    OpenPayerNPI Medicare & MedicaidMainehealth
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    Mainehealth — Billing Profile & Reimbursement Data

    NPI 1497068969 · Scarborough, ME · Family Medicine Physician

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    Mainehealth is a family medicine physician provider located in Scarborough, Maine. This profile covers 0 Medicare and 131 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
    Address300 Professional Dr
    CityScarborough
    StateME
    ZIP04074
    TaxonomyFamily Medicine Physician
    NPI EnumeratedJuly 26, 2010

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

    Payer SourceTotal Paid
    Medicaid$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.

    131 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient46,560$70$3.4M
    C9803Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source8,080$20$145.5K
    G0008Administration of influenza virus vaccine5,130$30$138.5K
    90832In 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…1,210$90$109.7K
    90677This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…560$190$108.5K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.3,860$30$100.3K
    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…1,620$60$100.1K
    99395The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.1,240$70$80.3K
    99396The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.1,250$60$79.7K
    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…1,190$60$74.8K

    Showing 1–10 of 131

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    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

    131 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient176018,740$60$4.6M
    U0003Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…30401,090$50$285.2K
    87636The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…28302,740$40$102.8K
    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…34701,060$40$97K
    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…26701,000$40$91K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.40402,130$20$89.9K
    97110Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…591501,160$20$82.7K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.3280540$40$61.6K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…37507,130$10$58.6K
    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.406012,710$1$57.8K

    Showing 1–10 of 131

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    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
    NordxMEClinical Medical Laboratory$2.4M$21.8M
    New England Life Care, Inc.MEHome Infusion Therapy Pharmacy$0$12.4M
    Northeast Mobile Health ServicesMEAmbulance$930.3K$9.5M
    Choices Are For Everyone, Inc.MEIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$9.7M
    Skilled Care SolutionsMEHome Health Agency$0$6.8M
    Surgi-care, IncMEProsthetic/Orthotic Supplier$0$5.6M
    MainehealthMENeurology Physician$0$4.2M
    MainehealthMECardiovascular Disease Physician$0$3.9M
    Maine Home Care SolutionsMEIn Home Supportive Care Agency$0$3.2M
    MainehealthMENeurological Surgery Physician$0$3.2M

    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 — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maine