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.

Central Maine Medical Center (NPI 1689653487)

Field	Value
Entity Type	Organization
Organization	Central Maine Medical Center
Address	300 Main St
City	Lewiston
State	ME
ZIP	04240
Taxonomy	General Acute Care Hospital
NPI Enumerated	January 11, 2006

Payer Source	Total Paid
Medicaid	$76.1M
Medicare	$0

Key Findings

CENTRAL MAINE MEDICAL CENTER is effectively a single‑payer Medicaid operation: there is no Medicare billing on file while lifetime Medicaid revenue is $76.1M. This concentration on Medicaid makes the provider’s revenue base highly dependent on state Medicaid volumes and reimbursement policies rather than dual-payer dynamics.

Revenue is highly concentrated in a very small set of outpatient and emergency visit codes: the precomputed top three Medicaid codes account for 54.6% of the provider’s total Medicaid revenue, led by G0463 ($16.2M, 29.0%), 99284 ($8.6M, 15.4%), and 99285 ($5.7M, 10.3%). These three lines alone generate more than half of reported Medicaid revenue, indicating operational reliance on clinic and ED throughput.

Service-line mix points to a hospital with heavy emergency and outpatient clinic throughput: G0463 shows 294.2K claims and 99284 and 99285 together report 63.6K and 24.9K claims respectively, which reflects large volumes of both outpatient clinic assessment and moderate-to-high complexity ED visits. The prominence of these codes suggests the facility functions as a primary regional access point for urgent and emergency care under Medicaid.

Ambulatory and primary care activity is also substantial: 99214 appears as an extreme outlier with 113.3K claims and $4.1M in revenue (7.3% of Medicaid revenue) and ranks #2 of 461 providers in-state (100th percentile), while 99213 records 74.6K claims and $1.9M revenue (3.3%). These volumes indicate a very large established-patient outpatient practice volume co-located with hospital services, supporting significant office-based care under Medicaid.

Beyond ED and office visits, the coding mix shows integrated procedural, infusion, and diagnostic services consistent with a full-service acute-care hospital: high-volume infusions/IV push codes (96374, 96365, 96375, 96360), chemotherapy (96413), advanced endoscopy (43239, 45380, 45385), imaging (74177, 70450), and echocardiography (93306) all appear in the top 25. Each of these lines contributes meaningful Medicaid revenue (examples: 43239 $1.5M, $1.7M, $521.6K), implying onsite specialty and procedural capacity beyond basic ED/clinic work.

Competitive standing in-state is strong across multiple high-revenue codes: G0463 ranks #4 of 55 (94th percentile), 99284 ranks #3 of 61 (97th percentile), 99285 ranks #4 of 56 (95th percentile), and 99214 is an extreme outlier at the 100th percentile. Vaccination administration (90471) is also an extreme outlier (rank #4 of 185, 98th percentile). These rank/percentile signals identify the provider as a major statewide contributor for ED, clinic, office visit, and preventive-vaccine volume.

The provider’s operational footprint includes significant emergency-transport activity (A0427: 7.4K claims, $1.4M revenue, 95th percentile) and typical imaging and diagnostic throughput (e.g., 74177 at $1M, 87th percentile; 70450 at $546.1K, 88th percentile), reinforcing that the facility functions as a regional hub handling acute arrivals and in‑hospital diagnostics. The combination of high ambulance, ED, imaging, and procedural volumes is consistent with integration of emergency intake and downstream inpatient/outpatient workflows.

CENTRAL MAINE MEDICAL CENTER has an established presence, with its NPI enumerated on 2006-01-11 (~20 years ago), which aligns with the broad service mix and high claim volumes observed. Given the provider’s long tenure and concentrated Medicaid-driven revenue (no Medicare billing on file), operational planning and contracting should prioritize Medicaid utilization trends and state policy changes that would disproportionately affect the facility’s largest revenue drivers.

Medicaid: Complete Services Breakdown

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

692 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	294,170	$60	$16.2M
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.	63,600	$140	$8.6M
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.	24,890	$230	$5.7M
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.	46,420	$100	$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…	113,340	$40	$4.1M
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…	74,560	$30	$1.9M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	18,170	$90	$1.7M
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.	6,740	$230	$1.5M
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	7,430	$190	$1.4M
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.	8,460	$120	$1M

Showing 1–10 of 692

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

Central Maine Medical Center — 8 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

692 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	4	60	18,740	$60	$4.6M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	4	10	7,510	$230	$1.6M
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.	3	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.	4	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.	4	50	11,590	$60	$942.4K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	6	10	200	$1,690	$796.1K
77412	The provider delivers radiation therapy at level 3 complexity. This includes photon therapy delivered to multiple isocenters, photon therapy with active motion management, total skin electron…	4	10	7,830	$100	$695.4K
J0585	Injection, onabotulinumtoxina, 1 unit	9	20	1,240	$380	$618.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	3	30	6,230	$70	$515.4K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	6	100	670	$200	$363.5K

Showing 1–10 of 692

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Benjamin Ditty	FL	Neurological Surgery Physician	$590.6K	$0
Daniel Rausch	ME	Hematology & Oncology Physician	$541K	$0
Danielle Stout	ME	Family Nurse Practitioner	$522.1K	$0
Julia Moukharskaya	ME	Hematology & Oncology Physician	$519.1K	$0
Julius Tabe	MA	Family Medicine Physician	$449.6K	$2.5K
Adheesh Agnihotri	FL	Clinical Cardiac Electrophysiology Physician	$235.7K	$0
Ronen Marmur	NY	Rheumatology Physician	$194.3K	$0
Andrei Zaslavsky	ME	Internal Medicine Physician	$187.1K	$0
Julie Suarez	NH	Internal Medicine Physician	$175.2K	$0
Danielle Pineda	NJ	Vascular Surgery Physician	$174.3K	$0

Nearby Providers

Other providers in the same ZIP code as Central Maine Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seniorsplus	ME	Case Management Agency	$0	$74.6M
Support Solutions Inc	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$72.9M
Alternative Services-ne, Inc.	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$71.6M
St. Mary's Regional Medical Center	ME	General Acute Care Hospital	$0	$67.4M
Coastal Community Care, LLC	ME	Community/Behavioral Health Agency	$0	$24.1M
Androscoggin Home Health Services, Inc.	ME	Home Health Agency	$0	$20.6M
R.i.s.e., Inc.	ME	In Home Supportive Care Agency	$0	$18.5M
Community Clinical Services, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$17.3M
Bright Future Healthier You	ME	Case Management Agency	$0	$17.1M
Pediatric Associates Of Lewiston P.A.	ME	Pediatrics Physician	$0	$13.2M

Central Maine Medical Center — Billing Profile & Reimbursement Data

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Central Maine Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References