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.

Belfast Pediatrics, LLC (NPI 1558436683)

Belfast Pediatrics, LLC is a pediatrics physician provider located in Belfast, Maine. This profile covers 0 Medicare and 39 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	Belfast Pediatrics, LLC
Address	16 Fahey St Ste 107
City	Belfast
State	ME
ZIP	04915
Taxonomy	Pediatrics Physician
NPI Enumerated	November 22, 2006

Payer Source	Total Paid
Medicaid	$1.6M
Medicare	$0

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

39 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…	4,660	$100	$479.6K
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…	6,630	$70	$450.5K
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…	1,720	$100	$164.9K
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…	1,140	$90	$103.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	4,640	$20	$102K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,060	$90	$100K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	1,490	$50	$67K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	2,910	$20	$64.1K
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…	240	$140	$33.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	240	$100	$24K

Showing 1–10 of 39

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

Belfast Pediatrics, LLC — 0 of 19 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

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	124	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…	108	480	1,030	$20	$128.9K
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…	27	70	1,060	$40	$97K
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…	31	70	1,000	$40	$91K
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…	94	170	380	$50	$63.7K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	30	80	540	$40	$61.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	24	190	390	$20	$42.6K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	39	90	150	$40	$31.9K
D1206	Topical Fluoride Treatment – Except Varnish; Therapeutic application for moderate to high caries risk patients	98	190	470	$10	$31.8K
90677	This 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…	33	40	230	$50	$22.6K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$14.2M
Mainehealth	ME	Critical Access Hospital	$0	$5.3M
Just Me Inc	ME	In Home Supportive Care Agency	$0	$3.1M
Broadreach Family And Community Services	ME	Local Education Agency (LEA)	$0	$1.5M
City Of Belfast	ME	Land Ambulance	$214.8K	$1.1M
Empowers: Employment Options, LLC	ME	Community/Behavioral Health Agency	$0	$1.2M
Dialysis Clinic Inc.	ME	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$852.4K
Searsport Counseling Associates	ME	Case Management Agency	$0	$732.4K
Searsport Counseling Associates	ME	Mental Health Counselor	$0	$715.8K
Therapy Partners LLC	ME	Physical Therapist	$0	$349K

Belfast Pediatrics, LLC — Billing Profile & Reimbursement Data

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Belfast Pediatrics, LLC — 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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