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.

Penobscot Community Health Center (NPI 1841475712)

Key Findings

Field	Value
Entity Type	Organization
Organization	Penobscot Community Health Center
Address	735 Wilson St
City	Brewer
State	ME
ZIP	04412
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	January 9, 2008

Payer Source	Total Paid
Medicaid	$24.6M
Medicare	$0

This provider is effectively single‑payer in scope: there is no Medicare billing on file while total Medicaid revenue is $24.6M, signaling that Medicaid is the primary revenue source for clinical operations. The organization’s NPI was enumerated 2008-01-09 (~18 years ago), indicating long-standing enrollment and an established presence in the community.

Revenue is highly concentrated: the precomputed top three Medicaid codes (T1015, G0467, G2025) account for 96.4% of this provider’s total Medicaid revenue. That concentration means a small set of encounter-based FQHC and clinic codes drive the vast majority of cashflow.

T1015 dominates the payer mix as the single largest revenue driver: 121.2K claims producing $21.7M revenue (88.4% of this provider's total Medicaid revenue). This billing profile is consistent with an FQHC operating on high-volume, all‑inclusive clinic visit bundles and suggests primary care and general outpatient encounters form the operational core.

G0467 is the second key FQHC visit code with 31.4K claims and $1.7M revenue (6.8% of total Medicaid revenue), where the provider ranks #2 of 80 in-state (99th percentile; extreme outlier). Together with the T1015 volume, this ranking indicates the provider is a major statewide delivery site for standard FQHC per‑visit services.

G2025 telehealth distant site payments are present but modest in revenue terms (2.9K claims, $308.1K revenue; 1.3% of total Medicaid revenue) and the provider ranks #3 of 68 in-state (97th percentile; typical, unremarkable volume). This shows telehealth is an established but secondary revenue stream versus in‑person bundled visits.

Behavioral health and screening services show outsized encounter volumes relative to their revenue share: 90834 (14.5K claims, $58.1K revenue; ranks #5 of 134 in-state, 97th percentile), 90832 (14K claims, $56.2K revenue; ranks #4 of 144, 98th percentile), and 96160 (4.7K claims, $18.7K revenue; ranks #1 of 30, 100th percentile; extreme outlier). These patterns point to integrated behavioral health and standardized screening workflows that appear material to visit mix even if reimbursement per claim is low.

Common E/M CPT activity is high in claim volume but low in revenue contribution: 99213 shows 66.8K claims for $200.4K (0.8% of Medicaid revenue) and ranks #6 of 483 in-state (99th percentile; extreme outlier). The combination of very high claim counts with low average paid/claim suggests many low‑unit, low‑paid outpatient encounters are being recorded alongside FQHC‑specific bundled codes.

From a competitive standpoint, the provider is a dominant statewide FQHC for core visit codes — T1015 (rank #3 of 180, 99th percentile; extreme outlier) and G0467 (rank #2 of 80, 99th percentile; extreme outlier) — placing it among the largest Medicaid visit billers in Maine. The provider’s heavy reliance on a narrow set of FQHC/clinic encounter codes implies sensitivity to changes in Medicaid policy or reimbursement for those specific codes.

Medicaid: Complete Services Breakdown

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

69 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	121,240	$180	$21.7M
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…	31,450	$50	$1.7M
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	2,930	$110	$308.1K
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…	66,820	$1	$200.4K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	3,740	$50	$186.9K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	8,870	$10	$62.1K
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…	14,530	$1	$58.1K
98941	The provider applies manipulation to influence joint and neurophysiological function by a variety of techniques and modalities in three to four spinal regions.	6,340	$10	$57K
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…	14,050	$1	$56.2K
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…	27,050	$1	$54.1K

Showing 1–10 of 69

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

Penobscot Community Health Center — 8 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

69 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	3	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…	2	80	3,000	$50	$269.8K
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…	27	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…	6	480	1,030	$20	$128.9K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	50	70	3,850	$20	$128.1K
90853	Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of…	12	40	330	$20	$124.1K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	71	70	1,060	$40	$97K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	7	30	640	$60	$96.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	68	150	1,160	$20	$82.7K
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	20	50	110	$60	$72.1K

Showing 1–10 of 69

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rww Outpatient Rehab Services, Inc.	ME	In Home Supportive Care Agency	$0	$36.5M
A&m Home Care Corp	ME	Personal Care Attendant	$0	$17.3M
Mainely Kids & Teens, LLC	ME	Pediatric Dentistry	$0	$9M
Manzo Corporation	ME	In Home Supportive Care Agency	$0	$8.5M
Higher Ground Services LLC	ME	Community/Behavioral Health Agency	$0	$5.7M
Total Renal Care Inc	ME	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.3M
Albert Adams	ME	Pediatrics Physician	$0	$1.1M
Autumn Of Life In Home Care	ME	In Home Supportive Care Agency	$0	$659.4K
A Time To Rise - Counseling & Wellness LLC	ME	Substance Use Disorder Rehabilitation Clinic/Center	$0	$556.6K
Gentle Hands Home Care	ME	Home Health Agency	$0	$382.3K

Penobscot Community Health Center — Billing Profile & Reimbursement Data

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Penobscot Community Health 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$27.3M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$20.3M
Penobscot Community Health Center	ME	Dentist	$0	$17.4M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$16M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$14.2M
Penobscot Community Health Center	ME	Specialist	$0	$5.6M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$5.6M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$4.1M
Penobscot Community Health Center	ME	Federally Qualified Health Center (FQHC)	$0	$3.2M
Penobscot Community Health Center	ME	Hearing and Speech Clinic/Center	$0	$2.7M