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.

Eastern Maine Medical Center (NPI 1790789147)

Field	Value
Entity Type	Organization
Organization	Eastern Maine Medical Center
Address	489 State St
City	Bangor
State	ME
ZIP	04401
Taxonomy	General Acute Care Hospital
NPI Enumerated	June 13, 2005

Payer Source	Total Paid
Medicaid	$159.3M
Medicare	$0

Key Findings

EASTERN MAINE MEDICAL CENTER appears to be effectively single-payer in the available data: there is no Medicare billing on file while total Medicaid revenue is $159.3M. The absence of Medicare activity combined with substantial Medicaid volume indicates the provider’s documented financial footprint in our dataset is concentrated entirely in Medicaid.

Revenue concentration is high: the precomputed top three Medicaid codes account for 54.7% of the provider’s total Medicaid revenue. Those top three contributors are G0463 ($34.3M, 32.3% of Medicaid revenue), 99285 ($16.4M, 15.5%), and J9271 ($7.3M, 6.9%), showing that a handful of services drive a majority of reported Medicaid receipts.

Operationally, the service mix points to a large hospital outpatient clinic and high-volume emergency department. G0463 shows 519.8K claims at $66 avg paid/claim ($34.3M revenue), and 99285 has 48.8K claims at $336 avg paid/claim ($16.4M revenue); together these counts and revenues indicate sustained, high-throughput outpatient and high-acuity ED activity rather than low-volume specialty-only operations.

Oncology and infusion are material revenue streams: J9271 (pembrolizumab) accounts for $7.3M (6.9%) and ranks #1 of 3 in-state, and J9299 (nivolumab) contributes $2.9M (2.7%) and ranks #1 of 2. Additional oncology-related items such as 96413 ($2.3M, rank #1 of 25), 77386 ($2.4M), and 78815 ($1.8M) further support a significant chemotherapy, biologic infusion, and advanced radiation/imaging footprint.

The provider shows unusually large ambulatory E/M volumes for the state: 99214 appears with 113.3K claims and $4.1M revenue (rank #3 of 461, 100th percentile; extreme outlier) while 99215 and 99213 also appear at high rank and volume. These patterns suggest robust outpatient clinic activity and high visit volumes across both lower- and higher-complexity office/clinic E/M codes.

Diagnostic and procedural services are prominent and state-leading in several areas: 93306 (echo) records $3M and ranks #1 of 44 (100th percentile; extreme outlier), 93303 records $1.4M and ranks #1 of 7 (100th percentile), and 43239 (upper endoscopy biopsy) contributes $1.5M and ranks #3 of 31. High-ranking imaging and endoscopy activity implies substantial in-house diagnostic capacity.

Competitive standing within Maine is strong for multiple high-revenue codes: the provider ranks in the 98th–100th percentiles or at #1 for several major services (examples include G0463 #2/55 98th percentile extreme outlier; 99285 #2/56 98th percentile extreme outlier; 99214 #3/461 100th percentile extreme outlier; 93306 #1/44 100th percentile extreme outlier). These rank/percentile patterns indicate the provider is a dominant statewide participant for many hospital-based outpatient, ED, imaging, and oncology services.

Tenure and profile: the NPI was enumerated on 2005-06-13 (~21 years ago), indicating a long-established facility in the region. Coupled with the concentrated Medicaid revenue ($159.3M) and the pattern of high-volume, high-complexity codes, the data are consistent with a mature general acute care hospital with substantial outpatient, ED, diagnostic, and oncology operations focused on the Medicaid population.

Medicaid: Complete Services Breakdown

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

888 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	519,820	$70	$34.3M
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.	48,840	$340	$16.4M
J9271	Injection, pembrolizumab, 1 mg	1,730	$4,210	$7.3M
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.	40,660	$130	$5.2M
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…	113,320	$40	$4.1M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	32,610	$90	$3M
J9299	Injection, nivolumab, 1 mg	720	$3,960	$2.9M
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,120	$2,280	$2.5M
J0585	Injection, onabotulinumtoxina, 1 unit	4,320	$560	$2.4M
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.	19,000	$130	$2.4M

Showing 1–10 of 888

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

Eastern Maine Medical Center — 17 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

888 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	Injection, pembrolizumab, 1 mg	1	10	1,500	$4,760	$6.4M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	2	60	18,740	$60	$4.6M
J1459	Injection, immune globulin (privigen), intravenous, non-lyophilized (e.g., liquid), 500 mg	2	10	1,620	$980	$1.6M
77386	Intensity modulated radiation treatment delivery (IMRT), includes guidance and tracking, when performed; complex	2	10	7,510	$230	$1.6M
J9299	Injection, nivolumab, 1 mg	1	10	430	$3,580	$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.	6	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.	2	60	4,690	$180	$1.5M
J0178	Injection, aflibercept, 1 mg	8	10	1,710	$620	$1.2M
J2505	Injection, pegfilgrastim, 6 mg	1	10	590	$1,860	$1.1M
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.	16	50	11,590	$60	$942.4K

Showing 1–10 of 888

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Houlton Regional Hospital	ME	Rural Health Clinic/Center	$0	$7M
Houlton Regional Hospital	ME	Critical Access Hospital	$0	$4.1M
Houlton Regional Hospital	ME	Rural Health Clinic/Center	$0	$3.1M
Michael Johnson	SC	Ophthalmology Physician	$3M	$0
Mrh Corp.	ME	Family Medicine Physician	$0	$1.9M
Mrh Corp.	ME	Internal Medicine Physician	$0	$661.4K
Kenneth Smith	DE	Internal Medicine Physician	$274.2K	$20.3K
Gabriel Thornton	GA	Critical Care Medicine (Internal Medicine) Physician	$241.4K	$0
Jessica Watson	ME	Ophthalmology Physician	$202.3K	$0
Ahmet Sayan	VI	Cardiovascular Disease Physician	$179.1K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Creative Options, LLC	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$78.7M
Mas Medical Staffing Corporation	ME	Community/Behavioral Health Agency	$0	$62.5M
Ohi	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$61.9M
Ohi	ME	Mental Illness Community Based Residential Treatment Facility	$0	$39.6M
St. Joseph Hospital	ME	General Acute Care Hospital	$0	$38.8M
Mert Enterprises, Inc.	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$36.3M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$27.3M
Amicus	ME	Developmentally Disabled Services Day Training Agency	$0	$26.1M
Branches, LLC	ME	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$25.4M
Lifeflight Of Maine, LLC	ME	Air Ambulance	$2.4M	$19.8M

Eastern 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