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.

Seaside Family Health Care LLC PA (NPI 1972093011)

Field	Value
Entity Type	Organization
Organization	Seaside Family Health Care LLC PA
Address	155 Saco Ave Ste 2a
City	Old Orchard Beach
State	ME
ZIP	04064
Taxonomy	Family Nurse Practitioner
NPI Enumerated	May 15, 2018

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2022	Case management, per month	1,500	$390	$581.2K
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…	4,680	$60	$295.1K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	1,500	$180	$265.5K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	1,500	$130	$200K
T1041	Medicaid certified community behavioral health clinic services, per month	120	$300	$37.4K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	120	$210	$24.8K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	150	$60	$8.7K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	70	$110	$7.2K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	1,560	$1	$4.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	30	$90	$2.8K

Showing 1–10 of 13

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

Seaside Family Health Care LLC PA — 0 of 13 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

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2022	Case management, per month	11	40	800	$190	$780.3K
H0047	Alcohol and/or other drug abuse services, not otherwise specified	6	30	750	$240	$312.9K
99408	The provider spends 15 to 30 minutes screening a patient for abuse of alcohol or another non–tobacco substance. The provider then performs a brief intervention at the same session.	7	30	740	$240	$301.1K
T1041	Medicaid certified community behavioral health clinic services, per month	7	10	440	$390	$226K
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…	123	460	1,240	$30	$190K
T1007	Alcohol and/or substance abuse services, treatment plan development and/or modification	7	10	440	$250	$142.1K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	144	170	380	$50	$63.7K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	101	140	470	$30	$59K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	22	60	40	$80	$15.4K
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,…	224	230	210	$10	$11.3K

Showing 1–10 of 13

Related Providers

Other providers that share a Tax Identification Number (TIN) with Seaside Family Health Care LLC PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Micah Malenfant	ME	Psychiatric/Mental Health Nurse Practitioner	$19.2K	$0

Nearby Providers

Other providers in the same ZIP code as Seaside Family Health Care LLC PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Shore Behavioral Health LLC	ME	Community/Behavioral Health Agency	$0	$9.2M
New Acadia Solutions LLC.	ME	In Home Supportive Care Agency	$0	$6.9M
Town Of Old Orchard Beach	ME	Land Ambulance	$143.2K	$732.5K

Seaside Family Health Care LLC PA — Billing Profile & Reimbursement Data

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Seaside Family Health Care LLC PA — 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