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.

Down East Community Hospital (NPI 1528087004)

Down East Community Hospital is a critical access hospital provider located in Machias, Maine. This profile covers 0 Medicare and 256 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	Down East Community Hospital
Address	11 Hospital Drive
City	Machias
State	ME
ZIP	04654
Taxonomy	Critical Access Hospital
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicaid	$4.5M
Medicare	$0

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

256 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	31,910	$20	$670.1K
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…	52,180	$10	$626.2K
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.	4,200	$80	$336K
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.	10,320	$20	$247.7K
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.	18,090	$10	$217.1K
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.	4,050	$50	$198.6K
99391	Preventive 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…	2,800	$50	$148.6K
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.	21,180	$10	$127.1K
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…	6,450	$20	$109.6K
99392	Preventive 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…	1,840	$50	$97.6K

Showing 1–10 of 256

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

Down East Community Hospital — 4 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

256 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.	22	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.	19	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.	15	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.	25	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.	15	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.	23	30	200	$250	$316.8K
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.	26	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.	7	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…	30	40	1,830	$90	$292.9K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	12	20	260	$370	$262.4K

Showing 1–10 of 256

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Down East Community Hospital	ME	Family Medicine Physician	$0	$2.1M
Down East Community Hospital	ME	Family Medicine Physician	$0	$1.8M
Michael Schekall	MN	Diagnostic Radiology Physician	$1.7M	$710
Krishna Iyer	MN	Vascular & Interventional Radiology Physician	$248K	$0
Shannon Daniels	MN	Diagnostic Radiology Physician	$165.5K	$0
Stephen Salzer	CT	Otolaryngology Physician	$165.4K	$0
David Cohen	ME	Pulmonary Disease Physician	$70.5K	$0
Kerry Crowley	ME	Family Medicine Physician	$60.3K	$0
Jeffrey Fecko	ME	Neurology Physician	$46.4K	$0
Steven Sauk	MO	Vascular & Interventional Radiology Physician	$23.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sunrise Opportunities	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$8.6M
Sunrise Opportunities	ME	Developmentally Disabled Services Day Training Agency	$0	$5.6M
Eastport Health Care, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$5.1M
Sunrise Opportunities	ME	Community/Behavioral Health Agency	$0	$1.1M
Sunrise Opportunities	ME	Case Management Agency	$0	$948.8K
Town Of Machias	ME	Land Ambulance	$183.7K	$505.2K
Michelle Del Tufo	ME	Physical Therapist	$90.7K	$0
Ernest Hayes, Dpm	ME	Podiatrist	$5.2K	$0

Down East Community Hospital — Billing Profile & Reimbursement Data

Sign up for Down East Community Hospital — Billing Profile & Reimbursement Data policy alerts

Down East Community Hospital — Billing Profile & Reimbursement Data

Sign up for Down East Community Hospital — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References