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.

Wilson Stream Family Practice LLC PA (NPI 1700259579)

Field	Value
Entity Type	Organization
Organization	Wilson Stream Family Practice LLC PA
Address	672 Wilton Rd
City	Farmington
State	ME
ZIP	04938
Taxonomy	Family Medicine Physician
NPI Enumerated	November 2, 2015

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1041	Medicaid certified community behavioral health clinic services, per month	710	$390	$272.6K
T2022	Case management, per month	640	$390	$249.2K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	710	$260	$180.5K
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…	2,310	$70	$159.2K
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…	2,440	$50	$126.8K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	650	$190	$124K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	650	$160	$100.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	390	$30	$9.8K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	80	$100	$8.4K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	80	$10	$960

Showing 1–10 of 30

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

Wilson Stream Family Practice LLC PA — 0 of 17 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	21	40	800	$190	$780.3K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	16	30	750	$240	$312.9K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	15	30	740	$240	$301.1K
T1041	Medicaid certified community behavioral health clinic services, per month	5	10	440	$390	$226K
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…	178	460	1,240	$30	$190K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	5	10	440	$250	$142.1K
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…	175	480	1,030	$20	$128.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	122	170	380	$50	$63.7K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	54	60	6,050	$10	$47.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	161	190	390	$20	$42.6K

Showing 1–10 of 30

Nearby Providers

Other providers in the same ZIP code as Wilson Stream Family Practice LLC PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$22.7M
Mainehealth	ME	Rural Health Clinic/Center	$0	$16.7M
Work First, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$7.2M
Mainehealth	ME	Rural Health Clinic/Center	$0	$2.4M
R.s.u. #9	ME	Local Education Agency (LEA)	$0	$2.3M
Mainehealth	ME	General Acute Care Hospital	$0	$1.4M
Farmington Oral & Facial Surgery P A	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$1.2M
Troy A Norton Od, Inc.	ME	Optometrist	$0	$481.5K
Mainehealth	ME	Critical Access Hospital	$0	$433.3K
Maine Growth Opportunities, Inc.	ME	Specialist	$0	$351.7K

Wilson Stream Family Practice LLC PA — Billing Profile & Reimbursement Data

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Wilson Stream Family Practice LLC PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References