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.

Sebasticook Family Doctors (NPI 1811223837)

Field	Value
Entity Type	Organization
Organization	Sebasticook Family Doctors
Address	29 Church St
City	Dexter
State	ME
ZIP	04930
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	October 27, 2009

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

44 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	19,810	$190	$3.7M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	2,290	$60	$146.3K
90834	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…	1,180	$90	$111.1K
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…	6,950	$10	$97.4K
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…	520	$80	$43.3K
D0140	Limited oral evaluation – problem focused	2,770	$10	$38.8K
D0120	Periodic oral evaluation - established patient	1,180	$20	$24.7K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	1,420	$20	$21.3K
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…	2,010	$10	$20.1K
D1120	Prophylaxis–child	2,090	$10	$18.8K

Showing 1–10 of 44

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

Sebasticook Family Doctors — 0 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

44 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	43	180	8,540	$180	$3M
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	46	80	3,000	$50	$269.8K
D7140	Extraction, erupted tooth or exposed root (elevation and/or forceps removal)	22	70	630	$100	$235.5K
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…	186	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…	101	480	1,030	$20	$128.9K
D2392	Post 2 surface resin‑based composite	49	80	260	$80	$88.2K
D1351	Sealant - per tooth	34	80	1,040	$20	$87.6K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	71	80	540	$40	$61.6K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	116	140	470	$30	$59K
D1120	Prophylaxis–child	39	160	500	$30	$56.2K

Showing 1–10 of 44

Related Providers

Other providers that share a Tax Identification Number (TIN) with Sebasticook Family Doctors, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$7.4M
Sebasticook Family Doctors	ME	Federally Qualified Health Center (FQHC)	$0	$394.3K
Ian Jones	ME	Optometrist	$80K	$0
Steven Badeen	ME	Family Medicine Physician	$65.3K	$0
Rebecca Beckwith	ME	Clinical Social Worker	$5.5K	$0

Nearby Providers

Other providers in the same ZIP code as Sebasticook Family Doctors, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maine School Administrative District No. 46	ME	Local Education Agency (LEA)	$0	$963.9K
Mrh Corp.	ME	Internal Medicine Physician	$0	$661.4K
Lisa Starkweather	ME	Nurse Practitioner	$27.4K	$0

Sebasticook Family Doctors — Billing Profile & Reimbursement Data

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Sebasticook Family Doctors — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References