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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMainehealth
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    Mainehealth — Billing Profile & Reimbursement Data

    NPI 1609180686 · Westbrook, ME · Family Medicine Physician

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    Mainehealth is a family medicine physician provider located in Westbrook, Maine. This profile covers 0 Medicare and 20 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMainehealth
    Address1 Harnois Ave
    CityWestbrook
    StateME
    ZIP04092
    TaxonomyFamily Medicine Physician
    NPI EnumeratedAugust 2, 2010

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$368K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    20 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient5,390$60$307.3K
    90832In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…260$80$20.7K
    G0008Administration of influenza virus vaccine710$20$16.9K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.520$20$11.4K
    90791In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.60$90$5.3K
    90686This 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…630$10$5.1K
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.20$60$930
    96127The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.40$10$230
    83036Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…40$1$40
    80305The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…10$1$10

    Showing 1–10 of 20

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Maine median

    20 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient386018,740$60$4.6M
    99393The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.7980540$40$61.6K
    90791In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.508090$50$53.3K
    90832In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…101140670$20$48.8K
    90471In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.79190390$20$42.6K
    G0008Administration of influenza virus vaccine53260110$20$17.8K
    83036Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…78801,120$1$16.4K
    0002AN/A1160100$20$11.2K
    0001AN/A117090$20$10.1K
    80305The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…65701,050$1$7K

    Showing 1–10 of 20

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    MainehealthMEGeneral Acute Care Hospital$0$142.6M
    MainehealthMECommunity/Behavioral Health Agency$0$115M
    MainehealthMEGeneral Acute Care Hospital$0$70.7M
    MainehealthMEGeneral Acute Care Hospital$0$40M
    MainehealthMEGeneral Acute Care Hospital$0$31.5M
    MainehealthMEGeneral Acute Care Hospital$0$22.7M
    MainehealthMERural Health Clinic/Center$0$16.7M
    MainehealthMEMulti-Specialty Clinic/Center$0$10.9M
    MainehealthMERural Health Clinic/Center$0$10M
    MainehealthMERural Health Clinic/Center$0$9.8M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Creative WorksMEDevelopmentally Disabled Services Day Training Agency$0$144.1M
    Woodfords Family ServicesMECommunity/Behavioral Health Agency$0$101.5M
    Safe Residential Care, LLCMEPhysical Disabilities Residential Treatment Facility$0$94.6M
    3rivers, Inc.MEIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$78.6M
    Woodfords Family ServicesMECommunity/Behavioral Health Agency$0$46.3M
    Alliance Case ManagementMECase Management Agency$0$17.8M
    Woodfords Family ServicesMEIn Home Supportive Care Agency$0$11.3M
    Woodfords Family ServicesMECase Management Agency$0$9.4M
    Mas Medical Staffing CorporationMEHome Health Agency$0$8.1M
    Maine Community HomecareMEIn Home Supportive Care Agency$0$8.1M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Maine Providers
    0 of 6 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Maine Distribution
    Mainehealth — 0 of 10 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maine