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.

Down East Community Hospital (NPI 1851397475)

Field	Value
Entity Type	Organization
Organization	Down East Community Hospital
Address	24 School St
City	Milbridge
State	ME
ZIP	04658
Taxonomy	Family Medicine Physician
NPI Enumerated	June 28, 2005

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1015	Clinic visit/encounter, all-inclusive	12,400	$100	$1.3M
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…	7,820	$40	$281.4K
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…	4,790	$50	$230K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	910	$20	$20.9K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	150	$40	$5.9K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	70	$70	$5K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,480	$1	$4.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	60	$70	$3.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	620	$1	$2.5K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	140	$20	$2.3K

Showing 1–10 of 25

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

Down East Community Hospital — 0 of 19 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	68	180	8,540	$180	$3M
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…	120	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…	93	480	1,030	$20	$128.9K
87637	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, influenza B, and respiratory syncytial virus (RSV)…	10	10	430	$60	$114.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	65	80	540	$40	$61.6K
G2025	Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only	40	70	220	$70	$54K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	54	190	390	$20	$42.6K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	67	90	400	$10	$32.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	80	90	150	$40	$31.9K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	55	70	260	$30	$26.8K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Down East Community Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Down East Community Hospital	ME	Critical Access Hospital	$0	$4.5M
Down East Community Hospital	ME	Family Medicine Physician	$0	$2.1M
Michael Schekall	MN	Diagnostic Radiology Physician	$1.7M	$710
Krishna Iyer	MN	Vascular & Interventional Radiology Physician	$248K	$0
Shannon Daniels	MN	Diagnostic Radiology Physician	$165.5K	$0
Stephen Salzer	CT	Otolaryngology Physician	$165.4K	$0
David Cohen	ME	Pulmonary Disease Physician	$70.5K	$0
Kerry Crowley	ME	Family Medicine Physician	$60.3K	$0
Jeffrey Fecko	ME	Neurology Physician	$46.4K	$0
Steven Sauk	MO	Vascular & Interventional Radiology Physician	$23.6K	$0

Nearby Providers

Other providers in the same ZIP code as Down East Community Hospital, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Compassionate Hearts Home Care	ME	In Home Supportive Care Agency	$0	$3.2M
The O.t. Spot, LLC	ME	Occupational Therapist	$0	$1.6M
Town Of Milbridge	ME	Land Ambulance	$57.6K	$97.2K
Thomas Crawford	ME	Optometrist	$23.9K	$123.7K

Down East Community Hospital — Billing Profile & Reimbursement Data

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Down East Community Hospital — 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