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.

Mainehealth (NPI 1639194509)

Mainehealth is a family medicine physician provider located in Portland, Maine. This profile covers 0 Medicare and 11 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	Mainehealth
Address	272 Congress St
City	Portland
State	ME
ZIP	04101
Taxonomy	Family Medicine Physician
NPI Enumerated	July 13, 2006

Payer Source	Total Paid
Medicaid	$394.2K
Medicare	$0

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

11 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…	7,210	$30	$223.4K
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…	6,870	$20	$158K
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…	220	$30	$5.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	150	$20	$2.6K
98925	The provider performs controlled manual pressure in one or two body regions to treat somatic and nonsomatic disorders.	190	$10	$1.5K
90832	In 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…	50	$20	$970
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	30	$30	$780
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	20	$40	$580
G0463	Hospital outpatient clinic visit for assessment and management of a patient	30	$10	$340
93793	The provider reviews and interprets a new INR test result of a patient taking regular doses of warfarin after which he adjusts the dosage if needed, instructs the patient on continued treatment, and…	50	$1	$90

Showing 1–10 of 11

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

Mainehealth — 0 of 10 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

11 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	54	60	18,740	$60	$4.6M
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…	81	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…	103	480	1,030	$20	$128.9K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	28	40	330	$20	$124.1K
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…	45	70	730	$30	$120.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	67	80	90	$50	$53.3K
90832	In 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…	126	140	670	$20	$48.8K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	18	30	50	$40	$6.3K
93793	The provider reviews and interprets a new INR test result of a patient taking regular doses of warfarin after which he adjusts the dosage if needed, instructs the patient on continued treatment, and…	3	10	60	$1	$3.3K
97810	The provider uses solid, metallic, fine, single–use needles to pierce the skin and stimulate anatomical points on or in the skin by manipulating the needles by hand during an initial 15 minute…	3	10	470	$1	$1.8K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Goodwill Industries Of Northern New England	ME	Comprehensive Outpatient Rehabilitation Facility (CORF)	$0	$106M
Maine Vocational Associates, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$34.3M
Catholic Charities Maine	ME	Clinical Social Worker	$0	$17.7M
Spurwink Services Incorporated	ME	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16.8M
Milestone Recovery	ME	Substance Abuse Rehabilitation Facility	$0	$8.8M
Portland Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$7.4M
Black Bear Medical, Inc.	ME	Customized Equipment (DME)	$0	$7.4M
Usa Family Well Being Services LLC	ME	Community/Behavioral Health Agency	$0	$6.3M
City Of Portland	ME	Land Ambulance	$740.2K	$5.4M
Maine Behavioral Healthcare	ME	Community/Behavioral Health Agency	$0	$4.9M

Mainehealth — Billing Profile & Reimbursement Data

Sign up for Mainehealth — Billing Profile & Reimbursement Data policy alerts

Mainehealth — Billing Profile & Reimbursement Data

Sign up for Mainehealth — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Mainehealth	ME	Community/Behavioral Health Agency	$0	$115M
Mainehealth	ME	General Acute Care Hospital	$0	$70.7M
Mainehealth	ME	General Acute Care Hospital	$0	$40M
Mainehealth	ME	General Acute Care Hospital	$0	$31.5M
Mainehealth	ME	General Acute Care Hospital	$0	$22.7M
Mainehealth	ME	Rural Health Clinic/Center	$0	$16.7M
Mainehealth	ME	Multi-Specialty Clinic/Center	$0	$10.9M
Mainehealth	ME	Rural Health Clinic/Center	$0	$10M
Mainehealth	ME	Rural Health Clinic/Center	$0	$9.8M