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.

Mainehealth (NPI 1841397932)

Mainehealth is a critical access hospital provider located in Belfast, Maine. This profile covers 0 Medicare and 371 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Mainehealth
Address	118 Northport Ave
City	Belfast
State	ME
ZIP	04915
Taxonomy	Critical Access Hospital
NPI Enumerated	September 20, 2006

Payer Source	Total Paid
Medicaid	$5.3M
Medicare	$0

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

371 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	2,790	$160	$455.1K
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.	29,960	$20	$449.4K
G0378	Hospital observation service, per hour	2,190	$140	$309.4K
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.	11,800	$30	$306.7K
G0463	Hospital outpatient clinic visit for assessment and management of a patient	45,390	$10	$272.3K
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…	3,670	$70	$249.4K
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…	33,040	$10	$198.2K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	2,510	$70	$185.5K
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.	22,400	$10	$156.8K
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,090	$130	$144.3K

Showing 1–10 of 371

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

Mainehealth — 3 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

371 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	18	60	18,740	$60	$4.6M
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.	13	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.	13	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.	13	50	11,590	$60	$942.4K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	15	30	6,230	$70	$515.4K
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.	25	60	2,380	$90	$345.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	9	30	880	$110	$338.4K
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.	25	30	200	$250	$316.8K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	6	40	5,020	$40	$302.3K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	14	40	3,970	$60	$299.5K

Showing 1–10 of 371

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$14.2M
Just Me Inc	ME	In Home Supportive Care Agency	$0	$3.1M
Belfast Pediatrics, LLC	ME	Pediatrics Physician	$0	$1.6M
Broadreach Family And Community Services	ME	Local Education Agency (LEA)	$0	$1.5M
City Of Belfast	ME	Land Ambulance	$214.8K	$1.1M
Empowers: Employment Options, LLC	ME	Community/Behavioral Health Agency	$0	$1.2M
Dialysis Clinic Inc.	ME	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$852.4K
Searsport Counseling Associates	ME	Case Management Agency	$0	$732.4K
Searsport Counseling Associates	ME	Mental Health Counselor	$0	$715.8K
Therapy Partners LLC	ME	Physical Therapist	$0	$349K

Mainehealth — Billing Profile & Reimbursement Data

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Mainehealth — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mainehealth	ME	General Acute Care Hospital	$0	$142.6M
Mainehealth	ME	Community/Behavioral Health Agency	$0	$115M
Mainehealth	ME	General Acute Care Hospital	$0	$70.7M
Mainehealth	ME	General Acute Care Hospital	$0	$40M
Mainehealth	ME	General Acute Care Hospital	$0	$31.5M
Mainehealth	ME	General Acute Care Hospital	$0	$22.7M
Mainehealth	ME	Rural Health Clinic/Center	$0	$16.7M
Mainehealth	ME	Multi-Specialty Clinic/Center	$0	$10.9M
Mainehealth	ME	Rural Health Clinic/Center	$0	$10M
Mainehealth	ME	Rural Health Clinic/Center	$0	$9.8M