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 1922791417)

Field	Value
Entity Type	Organization
Organization	Mainehealth
Address	111 Franklin Health Cmns
City	Farmington
State	ME
ZIP	04938
Taxonomy	Critical Access Hospital
NPI Enumerated	May 31, 2023

Payer Source	Total Paid
Medicaid	$433.3K
Medicare	$0

Medicaid: Complete Services Breakdown

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

210 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
A0425	Ground mileage, per statute mile	2,220	$10	$31K
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.	3,450	$10	$31K
A0428	Ambulance service, basic life support, non-emergency transport, (bls)	1,200	$20	$27.7K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	550	$50	$25.6K
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.	450	$50	$21.6K
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.	1,450	$10	$20.3K
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…	190	$70	$13.2K
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.	1,360	$10	$12.2K
Q9967	Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	680	$20	$11.6K
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.	260	$40	$11.5K

Showing 1–10 of 210

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 — 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

210 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	48	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.	37	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.	39	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.	40	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.	32	30	6,230	$70	$515.4K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	55	100	670	$200	$363.5K
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.	45	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…	23	30	880	$110	$338.4K
A0429	Ambulance service, basic life support, emergency transport (bls-emergency)	61	100	660	$180	$316.3K
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.	34	40	5,020	$40	$302.3K

Showing 1–10 of 210

Related Providers

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

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

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Work First, Inc.	ME	Developmentally Disabled Services Day Training Agency	$0	$7.2M
Mainehealth	ME	Rural Health Clinic/Center	$0	$2.4M
R.s.u. #9	ME	Local Education Agency (LEA)	$0	$2.3M
Mainehealth	ME	General Acute Care Hospital	$0	$1.4M
Wilson Stream Family Practice LLC PA	ME	Family Medicine Physician	$0	$1.2M
Farmington Oral & Facial Surgery P A	ME	Oral and Maxillofacial Surgery (Dentist)	$0	$1.2M
Troy A Norton Od, Inc.	ME	Optometrist	$0	$481.5K
Maine Growth Opportunities, Inc.	ME	Specialist	$0	$351.7K
Scott Weiner	ME	Orthopaedic Surgery Physician	$82.3K	$0
Richard Brown	ME	Ophthalmology Physician	$78.6K	$0

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