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    v1.0.28
    OpenPayerNPI Medicare & MedicaidMainehealth
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    Mainehealth — Billing Profile & Reimbursement Data

    NPI 1912204033 · Scarborough, ME · Pediatric Hematology & Oncology Physician

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    Mainehealth is a pediatric hematology & oncology physician provider located in Scarborough, Maine. This profile covers 0 Medicare and 20 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMainehealth
    Address100 Campus Dr
    CityScarborough
    StateME
    ZIP04074
    TaxonomyPediatric Hematology & Oncology Physician
    NPI EnumeratedFebruary 25, 2011

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$521.7K
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    20 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient5,200$90$488.8K
    96365The 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.80$170$13.4K
    96409In this procedure, the provider administers the chemotherapy drug using an intravenous push technique. Use this code when the provider administers a single or initial drug.30$170$5.3K
    96375Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…130$30$4.5K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…2,490$1$2.5K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.1,900$1$1.9K
    G0008Administration of influenza virus vaccine60$30$1.8K
    96167The provider, typically a psychologist, interviews the patient’s family in the presence of the patient and counsels them on strategies to change family dynamics and behaviors that adversely affect…130$10$1.2K
    90686This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…60$20$1.1K
    Q3014Telehealth originating site facility fee30$20$480

    Showing 1–10 of 20

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Maine median

    20 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0463Hospital outpatient clinic visit for assessment and management of a patient406018,740$60$4.6M
    96365The 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.36403,970$60$299.5K
    96375Following the administration of a drug or other substance via intravenous, or IV, push, the provider sequentially infuses a different medication or medications, also via IV push. He administers the…35405,160$20$137.5K
    80053The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.426012,710$1$57.8K
    96409In this procedure, the provider administers the chemotherapy drug using an intravenous push technique. Use this code when the provider administers a single or initial drug.310240$110$33.3K
    Q3014Telehealth originating site facility fee4960360$10$31.2K
    85025A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…41804,330$1$30.3K
    G0008Administration of influenza virus vaccine170260110$20$17.8K
    82728The lab analyst measures the level of ferritin, an important protein composed of about 20 percent iron. Ferritin also acts as an iron reserve in the body, and is present in serum in only minute…59601,610$1$11.6K
    36415In this procedure, the provider inserts a needle into a vein to collect a blood sample.81160770$1$7.8K

    Showing 1–10 of 20

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    MainehealthMEGeneral Acute Care Hospital$0$142.6M
    MainehealthMECommunity/Behavioral Health Agency$0$115M
    MainehealthMEGeneral Acute Care Hospital$0$70.7M
    MainehealthMEGeneral Acute Care Hospital$0$40M
    MainehealthMEGeneral Acute Care Hospital$0$31.5M
    MainehealthMEGeneral Acute Care Hospital$0$22.7M
    MainehealthMERural Health Clinic/Center$0$16.7M
    MainehealthMEMulti-Specialty Clinic/Center$0$10.9M
    MainehealthMERural Health Clinic/Center$0$10M
    MainehealthMERural Health Clinic/Center$0$9.8M

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    NordxMEClinical Medical Laboratory$2.4M$21.8M
    New England Life Care, Inc.MEHome Infusion Therapy Pharmacy$0$12.4M
    Northeast Mobile Health ServicesMEAmbulance$930.3K$9.5M
    Choices Are For Everyone, Inc.MEIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$9.7M
    Skilled Care SolutionsMEHome Health Agency$0$6.8M
    Surgi-care, IncMEProsthetic/Orthotic Supplier$0$5.6M
    MainehealthMEFamily Medicine Physician$0$5M
    MainehealthMENeurology Physician$0$4.2M
    MainehealthMECardiovascular Disease Physician$0$3.9M
    Maine Home Care SolutionsMEIn Home Supportive Care Agency$0$3.2M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Maine Providers
    0 of 6 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Maine Distribution
    Mainehealth — 0 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Maine