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NPI 1710942875 · Scarborough, ME · Diagnostic Radiology Physician
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Insight-premier Health LLC is a diagnostic radiology physician provider located in Scarborough, Maine. This profile covers 34 Medicare and 14 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Insight-premier Health LLC |
| Address | 400 Technology Way Ste A |
| City | Scarborough |
| State | ME |
| ZIP | 04074 |
| Taxonomy | Diagnostic Radiology Physician |
| NPI Enumerated | April 19, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $637.6K |
| Medicare | $405K |
INSIGHT-PREMIER HEALTH LLC is a diagnostic radiology operation focused on cross-sectional imaging: its Medicare top revenue codes are dominated by MRI of the lumbar spine (72148), CT abdomen/pelvis with contrast (74177), and contrast-enhanced abdominal MRI (74183), while Medicaid revenue is concentrated in spinal and extremity MRI codes (72148, 73721, 72141). This mix of high-volume MRI spine, joint MRIs, and CT abdomen/pelvis indicates on-site MRI and CT capacity with routine use of contrast-enhanced studies across payers.
Revenue concentration differs markedly by payer: the provider’s top 3 Medicare codes account for 33.4% of its total Medicare revenue, while the top 3 Medicaid codes account for 69.0% of its total Medicaid revenue. In particular, the Medicaid book of business is highly concentrated in a few MRI codes, increasing dependence on those service lines for state-reimbursed volume.
The provider’s payer mix is Medicaid-weighted in scale: lifetime Medicare revenue is $405K compared with lifetime Medicaid revenue of $637.6K, so Medicaid represents the larger portion of recorded public-payer receipts. This profile is not single-payer — both payers appear active — but the commercial/public split likely leans toward substantial Medicaid utilization.
On national Medicare measures the practice posts standout volume for specific codes: 72148 ranks #472 of 14990 providers (97th percentile) and 71271 ranks #417 of 8424 providers (95th percentile), each described as notably above typical national volume for those codes. Several other MRI codes (for example 70551 and 73221) fall in the 90%+ percentiles as well, indicating above-typical national participation in multiple MR imaging categories rather than a uniformly high-volume national footprint across all services.
Within Maine Medicaid the provider’s competitive standing is strong for spinal and extremity MRI: 72148 ranks #6 of 42 in-state (88th percentile), 73721 ranks #5 of 30 (86th percentile), 72141 ranks #5 of 18 (76th percentile), and 73221 ranks #3 of 19 (89th percentile). The high in-state ranks for these MRI codes — together with A9575 for gadoterate meglumine at #2 of 15 in-state (93rd percentile, noted as above typical state volume) — point to a significant regional position for contrast-enhanced and spine/extremity MRI services.
Contrast and supply billing patterns corroborate a service-line emphasis on contrast-enhanced studies: Medicaid claims include A9575 (1.6K claims, $11 avg paid/claim, $17.9K revenue, 2.8% of Medicaid revenue) and Q9967 (949 claims, $5 avg paid/claim, $4.7K revenue, 0.7%), suggesting routine use of gadolinium-based and iodinated contrast in the outpatient imaging mix. High ranks for contrast supply codes at the state level reinforce that contrast-enhanced MRI/CT is a routine part of the provider’s workflow.
72148 is a primary revenue driver across payers and is especially dominant in Medicaid where it generates $216.2K revenue (33.9% of the provider’s total Medicaid revenue) compared with $53K on Medicare (13.9% of Medicare revenue). This difference highlights the provider’s reliance on lumbar spine MRI in its state payer mix and suggests that any changes to reimbursement or referral patterns for spine MRI could materially affect total Medicaid revenue.
The practice has a long-tenured NPI (enumerated 2006-04-19, ~20 years ago), consistent with an established imaging operation. Coupled with concentrated MRI volumes and above-typical rank positions for several spine, extremity, and screening CT codes, the data indicate a stable, specialty-focused imaging provider with measurable regional market strength in MRI services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
34 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 72148 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast. | 360 | $150 | $53K |
| 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. | 160 | $240 | $38.1K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 130 | $270 | $36.3K |
| 70553 | In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows… | 130 | $240 | $32.3K |
| 70551 | The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam. | 210 | $150 | $31.4K |
| 73721 | In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material. | 190 | $150 | $28.8K |
| 73221 | In this diagnostic procedure, the provider performs a magnetic resonance imaging, or MRI imaging, of any of the joints of a patient’s upper extremity, which can be the shoulder, elbow, wrist, or… | 170 | $150 | $25.8K |
| 72141 | In this diagnostic procedure, the provider performs a magnetic resonance imaging (MRI) study of the cervical spinal canal and contents without using contrast material. | 140 | $140 | $19.2K |
| 71271 | The provider performs a low–dose computed tomography (LDCT), with low–dose ionizing radiation, for examination of the thorax without using contrast material to screen for lung cancer. | 130 | $130 | $17.3K |
| 72158 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents first without using contrast and again after injecting contrast material. | 60 | $250 | $14.6K |
Showing 1–10 of 34
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 34 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
14 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 72148 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast. | 1,970 | $110 | $216.2K |
| 73721 | In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material. | 970 | $130 | $121.6K |
| 72141 | In this diagnostic procedure, the provider performs a magnetic resonance imaging (MRI) study of the cervical spinal canal and contents without using contrast material. | 920 | $110 | $101.4K |
| 70551 | The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam. | 560 | $100 | $56.1K |
| 73221 | In this diagnostic procedure, the provider performs a magnetic resonance imaging, or MRI imaging, of any of the joints of a patient’s upper extremity, which can be the shoulder, elbow, wrist, or… | 500 | $110 | $52.5K |
| 70553 | In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows… | 150 | $210 | $31K |
| A9575 | Injection, gadoterate meglumine, 0.1 ml | 1,630 | $10 | $17.9K |
| 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. | 110 | $130 | $14.1K |
| 71271 | The provider performs a low–dose computed tomography (LDCT), with low–dose ionizing radiation, for examination of the thorax without using contrast material to screen for lung cancer. | 120 | $70 | $7.8K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 50 | $120 | $5.3K |
Showing 1–10 of 14
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
14 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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. | 52 | 60 | 2,380 | $90 | $345.7K |
| 70553 | In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows… | 10 | 20 | 270 | $160 | $166.5K |
| 70551 | The provider uses magnetic resonance imaging, or MRI, to examine the brain and brain stem. The provider does not administer contrast for this exam. | 13 | 40 | 360 | $90 | $78.8K |
| 72141 | In this diagnostic procedure, the provider performs a magnetic resonance imaging (MRI) study of the cervical spinal canal and contents without using contrast material. | 5 | 20 | 440 | $110 | $59.2K |
| 72148 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast. | 6 | 40 | 260 | $80 | $58K |
| 74183 | The provider performs magnetic resonance imaging of the structures and organs of the abdomen, initially without control and then with additional sequences after injection of contrast. | 8 | 10 | 170 | $110 | $55K |
| 73721 | In this diagnostic procedure, the provider performs magnetic resonance imaging of a lower extremity joint without using contrast material. | 5 | 30 | 250 | $100 | $48.6K |
| 71250 | In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax without using contrast material. | 36 | 40 | 310 | $40 | $39.2K |
| 72158 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents first without using contrast and again after injecting contrast material. | 4 | 10 | 200 | $120 | $25.4K |
| 73221 | In this diagnostic procedure, the provider performs a magnetic resonance imaging, or MRI imaging, of any of the joints of a patient’s upper extremity, which can be the shoulder, elbow, wrist, or… | 3 | 20 | 130 | $90 | $23.6K |
Showing 1–10 of 14
Other providers in the same ZIP code as Insight-premier Health LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Nordx | ME | Clinical Medical Laboratory | $2.4M | $21.8M |
| New England Life Care, Inc. | ME | Home Infusion Therapy Pharmacy | $0 | $12.4M |
| Northeast Mobile Health Services | ME | Ambulance | $930.3K | $9.5M |
| Choices Are For Everyone, Inc. | ME | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | $0 | $9.7M |
| Skilled Care Solutions | ME | Home Health Agency | $0 | $6.8M |
| Surgi-care, Inc | ME | Prosthetic/Orthotic Supplier | $0 | $5.6M |
| Mainehealth | ME | Family Medicine Physician | $0 | $5M |
| Mainehealth | ME | Neurology Physician | $0 | $4.2M |
| Mainehealth | ME | Cardiovascular Disease Physician | $0 | $3.9M |
| Maine Home Care Solutions | ME | In Home Supportive Care Agency | $0 | $3.2M |
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