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.

Penobscot Valley Hospital (NPI 1588995948)

Field	Value
Entity Type	Organization
Organization	Penobscot Valley Hospital
Address	252 Enfield Rd
City	Lincoln
State	ME
ZIP	04457
Taxonomy	Rural Health Clinic/Center
NPI Enumerated	January 26, 2010

Payer Source	Total Paid
Medicaid	$1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	11,610	$80	$963.9K
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…	5,310	$10	$37.1K
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…	6,980	$10	$34.9K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	120	$40	$4.2K
99441	N/A	60	$60	$3.9K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	330	$10	$2.7K
99442	N/A	20	$100	$1.6K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	90	$10	$680
99203	The provider sees a new 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 provider…	70	$10	$590
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	600	$0	$0

Showing 1–10 of 13

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

Penobscot Valley Hospital — 0 of 9 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	74	180	8,540	$180	$3M
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…	110	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…	98	480	1,030	$20	$128.9K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	47	70	220	$70	$54K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	74	190	390	$20	$42.6K
99203	The provider sees a new 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 provider…	125	170	220	$30	$24.4K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	86	190	110	$1	$5.7K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	9	30	100	$10	$5.4K
99348	The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves low medical decision making or the provider spends at least 30…	8	10	220	$10	$4.3K
99442	N/A	61	70	50	$10	$1.7K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Penobscot Valley Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Penobscot Valley Hospital	ME	Critical Access Hospital	$0	$1.3M
Alaa Ayyoub	WA	Interventional Cardiology Physician	$57.6K	$0
Daniel Stanhiser	ME	Family Medicine Physician	$56.5K	$0
Anas Mansour	ME	Cardiovascular Disease Physician	$55.8K	$0
Mohamed Shokr	ME	Clinical Cardiac Electrophysiology Physician	$54.6K	$0
Brian Berberian	ME	Gastroenterology Physician	$51.2K	$0
Thomas Earl	ME	Interventional Cardiology Physician	$50K	$0
Spyridon Akrivakis	ME	Clinical Cardiac Electrophysiology Physician	$49.8K	$0
Sreedhar Reddy Madireddy	NC	Cardiovascular Disease Physician	$49.3K	$0
Juan Merchan Hakspiel	ME	Clinical Cardiac Electrophysiology Physician	$48K	$0

Nearby Providers

Other providers in the same ZIP code as Penobscot Valley Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
R & C Home Care, Inc.	ME	In Home Supportive Care Agency	$0	$13.5M
Health Access Network Inc	ME	Federally Qualified Health Center (FQHC)	$0	$11.7M
Mc Community Services	ME	Community/Behavioral Health Agency	$0	$8.1M
Turning Point Mental Health Professionals LLC	ME	Counselor	$0	$2.2M
Health Access Network, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$1.6M
Total Renal Care Inc	ME	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$816.2K
Town Of Lincoln	ME	Ambulance	$126K	$492.8K
Devesh Agarwal	ME	Family Medicine Physician	$79.8K	$0
Gary Degen	ME	Foot & Ankle Surgery Podiatrist	$27.9K	$0
Tammy Webb	ME	Physician Assistant	$16.7K	$0

Penobscot Valley Hospital — Billing Profile & Reimbursement Data

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Penobscot Valley 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

Related Providers

Nearby Providers

Frequently Asked Questions

References