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.

Northern Maine Medical Center (NPI 1568465144)

Northern Maine Medical Center is a critical access hospital provider located in Fort Kent, Maine. This profile covers 0 Medicare and 191 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	Northern Maine Medical Center
Address	194 East Main Street
City	Fort Kent
State	ME
ZIP	04743
Taxonomy	Critical Access Hospital
NPI Enumerated	May 27, 2005

Payer Source	Total Paid
Medicaid	$5.8M
Medicare	$0

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

191 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	12,660	$100	$1.2M
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.	7,360	$110	$787K
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.	3,810	$150	$578.7K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	12,340	$40	$431.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	8,350	$40	$325.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	2,750	$80	$214.2K
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.	2,910	$60	$177.2K
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.	2,380	$70	$176K
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…	910	$150	$132.3K
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…	6,700	$20	$120.5K

Showing 1–10 of 191

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

Northern Maine Medical Center — 1 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

191 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	31	60	18,740	$60	$4.6M
T1015	Clinic visit/encounter, all-inclusive	176	180	8,540	$180	$3M
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.	27	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.	32	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.	32	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.	27	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.	29	60	2,380	$90	$345.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	24	30	880	$110	$338.4K
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.	16	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.	32	40	5,020	$40	$302.3K

Showing 1–10 of 191

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Maine Medical Center	ME	Rural Health Clinic/Center	$0	$3M
Northern Maine Medical Center	ME	Rural Health Clinic/Center	$0	$2.8M
Bogdan Cherascu	IA	Rheumatology Physician	$2.4M	$0
Allan Espinosa Morazan	AZ	Medical Oncology Physician	$2.2M	$0
Northern Maine Medical Center	ME	Rural Health Clinic/Center	$0	$1.5M
Northern Maine Medical Center	ME	Rural Health Clinic/Center	$0	$1.3M
Steven Hake	CO	Diagnostic Radiology Physician	$982.7K	$0
Alan Mautz	WI	Diagnostic Radiology Physician	$430.5K	$1.7K
Iqra Choudary	NY	Hematology & Oncology Physician	$406.5K	$1.9K
Elliott Wagner	CA	Diagnostic Radiology Physician	$392.6K	$7.3K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Fish River Rural Health	ME	Federally Qualified Health Center (FQHC)	$0	$7.7M
Fish River Rural Health	ME	Federally Qualified Health Center (FQHC)	$0	$1.3M
Ambulance Service Inc.	ME	Land Ambulance	$223.7K	$733.4K
Polished Oral Health, LLC	ME	Dental Hygienist	$0	$371.9K
John Hotchkiss	ME	Diagnostic Radiology Physician	$93.6K	$61.4K
James Harris	ME	Internal Medicine Physician	$91.7K	$0
Northern Maine Medical Center	ME	Community/Retail Pharmacy	$71.3K	$280
Savannah Paradis-hamilton	ME	Occupational Therapist	$51.2K	$0
Timothy Rioux	ME	Optometrist	$50.2K	$0
Matthew Michaud	ME	Physical Therapist	$43.8K	$0

Northern Maine Medical Center — Billing Profile & Reimbursement Data

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Northern Maine Medical Center — 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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