Loading...
NPI 1982153052 · Lewiston, ME · Mobile Radiology Clinic/Center
Customize your policy alerts
Get alerted when relevant policies change without checking for updates manually.
Monitor payer policy activity
Shields Pet/ct At Cmmc, LLC is a mobile radiology clinic/center provider located in Lewiston, Maine. This profile covers 4 Medicare and 2 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Shields Pet/ct At Cmmc, LLC |
| Address | 300 Main St |
| City | Lewiston |
| State | ME |
| ZIP | 04240 |
| Taxonomy | Mobile Radiology Clinic/Center |
| NPI Enumerated | September 29, 2016 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $481.5K |
| Medicare | $408.5K |
SHIELDS PET/CT AT CMMC, LLC presents as a focused mobile PET/CT imaging operation consistent with its listed taxonomy (Mobile Radiology Clinic/Center); billing is dominated by PET/CT imaging and radiopharmaceutical supply codes such as 78815, A9595, and A9552, which together drive the bulk of its imaging business. The presence of both procedure codes (78815) and tracer supply codes (A9595, A9552) indicates the provider performs imaging and bills for the diagnostic radiopharmaceuticals used in PET studies, consistent with a vertically integrated mobile PET/CT service model.
Medicare revenue is highly concentrated: the top 3 Medicare codes account for 92.8% of the provider's total Medicare revenue, with 78815 alone representing $173.6K (42.5% of Medicare revenue) across 165 claims at an average paid/claim of $1052. This concentration means shifts in utilization or reimbursement for those few codes would materially affect the provider's Medicare topline.
On Medicaid this concentration is even more pronounced: the top 3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, with 78815 generating $337.3K (70.1% of Medicaid revenue) across 998 claims at $338 avg paid/claim and A9552 contributing $143.8K (29.9% of Medicaid revenue) across 946 claims at $152 avg paid/claim. The Medicaid revenue profile shows the operation is effectively single-service line for that payer, reliant on PET/CT studies and FDG tracer supply.
Payer mix shows Medicaid slightly outweighing Medicare in lifetime revenue: total Medicaid revenue is $481.5K compared with total Medicare revenue of $408.5K, indicating the provider draws slightly more revenue from Medicaid overall. This near-parity but Medicaid-leaning mix suggests contracting and reimbursement dynamics with the state program are important to the provider's financial picture.
Competitive standing for the provider's top Medicare codes is modest on a national scale: 78815 ranks #1247 of 6566 providers nationally (81th percentile, described as typical, unremarkable volume), A9595 ranks #190 of 528 (64th percentile, typical, unremarkable volume), and A9552 ranks #413 of 2411 (83th percentile, typical, unremarkable volume). These placements indicate the provider is not a dominant national player for these procedures but maintains activity levels in line with many peers.
Within the state Medicaid market the provider is a mid-tier participant for its leading codes: 78815 ranks #5 of 12 providers in-state (64th percentile, typical, unremarkable volume) and A9552 ranks #4 of 8 (57th percentile, typical, unremarkable volume). The in-state ranks imply it is one of a small set of mobile/center-based PET/CT suppliers but not the clear market leader.
The provider's Medicare billing mix includes a minor additional PET code 78816 (28 claims, $1044 avg paid/claim, $29.2K revenue, 7.2% of Medicare revenue), showing some variation in imaging CPT usage beyond the top three codes; however, this code remains a small share relative to the concentrated top-three basket. Monitoring utilization of lower-share codes like 78816 could signal service diversification but currently does not materially change the revenue concentration risk.
Operational tenure is established but relatively recent in national provider terms: NPI enumerated 2016-09-29 (~10 years ago), which is sufficient time to have built Medicaid and Medicare referral relationships but still places the entity as a comparatively young practice compared with long-established imaging centers. Tenure combined with a concentrated code mix implies a focused growth or referral strategy centered on PET/CT imaging and radiotracer services.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 170 | $1,050 | $173.6K |
| A9595 | Piflufolastat f-18, diagnostic, 1 millicurie | 300 | $480 | $141.1K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 160 | $410 | $64.5K |
| 78816 | The patient is injected with a radiopharmaceutical tracer called FDG (fluoro–deoxyglucose, a radioactive substance containing glucose) about one hour before the imaging is scheduled to begin. The… | 30 | $1,040 | $29.2K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.
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
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
2 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 1,000 | $340 | $337.3K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 950 | $150 | $143.8K |
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
2 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 78815 | PET and CT scans are both standard imaging tools that allow doctors to evaluate the location and metabolic actions of tumors or cancer inside the body before beginning an active treatment regimen.… | 5 | 10 | 640 | $400 | $451.6K |
| A9552 | Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries | 4 | 10 | 590 | $20 | $26.3K |
Other providers in the same ZIP code as Shields Pet/ct At Cmmc, LLC, ranked by combined Medicare and Medicaid revenue.
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.