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.

Houlton Regional Hospital (NPI 1508823741)

Houlton Regional Hospital is a critical access hospital provider located in Houlton, Maine. This profile covers 0 Medicare and 223 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	Houlton Regional Hospital
Address	20 Hartford St
City	Houlton
State	ME
ZIP	04730
Taxonomy	Critical Access Hospital
NPI Enumerated	May 1, 2006

Payer Source	Total Paid
Medicaid	$4.1M
Medicare	$0

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

223 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.	18,080	$40	$668.9K
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.	3,920	$80	$325.4K
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.	5,230	$50	$277.2K
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.	21,050	$10	$273.7K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	7,520	$40	$270.5K
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.	3,160	$80	$243.5K
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.	16,810	$10	$201.7K
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…	2,490	$60	$154.3K
96361	The provider administers intravenous, or IV, fluids with electrolytes through an already established intravenous route for each additional hour to treat more severe dehydration.	5,840	$30	$151.9K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	8,740	$10	$122.3K

Showing 1–10 of 223

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

Houlton Regional Hospital — 0 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

223 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	39	60	18,740	$60	$4.6M
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.	18	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.	7	60	4,690	$180	$1.5M
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.	21	50	11,590	$60	$942.4K
J0585	Injection, onabotulinumtoxina, 1 unit	12	20	1,240	$380	$618.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	21	30	6,230	$70	$515.4K
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.	16	60	2,380	$90	$345.7K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	9	40	5,020	$40	$302.3K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	8	40	3,970	$60	$299.5K
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…	16	40	1,830	$90	$292.9K

Showing 1–10 of 223

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eastern Maine Medical Center	ME	General Acute Care Hospital	$0	$159.3M
Houlton Regional Hospital	ME	Rural Health Clinic/Center	$0	$7M
Houlton Regional Hospital	ME	Rural Health Clinic/Center	$0	$3.1M
Michael Johnson	SC	Ophthalmology Physician	$3M	$0
Mrh Corp.	ME	Family Medicine Physician	$0	$1.9M
Mrh Corp.	ME	Internal Medicine Physician	$0	$661.4K
Kenneth Smith	DE	Internal Medicine Physician	$274.2K	$20.3K
Arjun Sood	VA	Hematology & Oncology Physician	$262.9K	$0
Rakesh Chaudhari	IL	Diagnostic Radiology Physician	$145K	$107.1K
Gabriel Thornton	GA	Critical Care Medicine (Internal Medicine) Physician	$241.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Living Association	ME	Nursing Care Agency	$0	$30.4M
Katahdin Valley Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$22.5M
Houlton Band Of Maliseet Indians	ME	Clinic/Center	$0	$4.3M
A New Start LLC	ME	Social Worker	$0	$3.5M
Town Of Houlton	ME	Land Ambulance	$243.2K	$1.6M
Abc Behave LLC	ME	Developmental Therapist	$0	$1.4M
Southern Aroostook Ems Authority	ME	Land Ambulance	$126.7K	$343.9K
Simon Ouaknine	ME	Urology Physician	$129.2K	$120
Owen Igbinosa	ME	Internal Medicine Physician	$127.8K	$0
Shahriar Anoushfar	ME	Surgery Physician	$64.6K	$0

Houlton Regional Hospital — Billing Profile & Reimbursement Data

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Houlton Regional Hospital — 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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