Physician
Mainehealth
Mainehealth was paid $1.33M by Medicaid between Jan 2018 and Dec 2023, across 54 billing codes. Its largest line is G0463, Hospital outpatient clinic visit for assessment and management of a patient — 66% of everything it billed.
33Billing provider infoMAINEHEALTH
WINDHAM, ME 04062
WINDHAM, ME 04062
33aNPI1023321593assigned 07/26/2010
33bProvider typePediatrics Physician
28Total paid$1.33M
24GClaims28,042
24DCodes billed54
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other Pediatrics Physician providers in Maine
Rank by total paid#5 of 22
Median peer was paid$76K
This provider vs. median17×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Auditor's notes
Automated statistical signals. Not evidence of fraud — how these are computed.
Entity ProliferationAuthorized official INZANA, LUGENE controls 20+ related entities in our dataset. Read more
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 4,849 | $223K | |
| 2019 | 4,790 | $206K | |
| 2020 | 3,889 | $163K | |
| 2021 | 4,640 | $219K | |
| 2022 | 5,031 | $242K | |
| 2023 | 4,843 | $274K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| G0463 | Hospital outpatient clinic visit for assessment and management of a patient | 66% | 11,600 | 10,357 | $883K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 5.9% | 2,510 | 2,432 | $79K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 5.3% | 1,169 | 1,162 | $71K |
| G0008 | Administration of influenza virus vaccine | 4.9% | 2,297 | 2,264 | $65K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 4.3% | 938 | 929 | $57K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 3.9% | 856 | 832 | $52K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 2.5% | 536 | 535 | $34K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.7% | 336 | 326 | $23K |
| G0009 | Administration of pneumococcal vaccine | 1.1% | 478 | 475 | $14K |
| 90686 | <1% | 2,208 | 2,178 | $12K | |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 102 | 88 | $11K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 146 | 142 | $10K |
42 more codes
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | <1% | 151 | $3K |
| 90677 | <1% | 13 | $2K | |
| 90670 | <1% | 433 | $2K | |
| 96127 | <1% | 312 | $2K | |
| Q3014 | Telehealth originating site facility fee | <1% | 138 | $2K |
| 0054A | <1% | 74 | $2K | |
| 0124A | <1% | 151 | $2K | |
| 0001A | <1% | 37 | $1K | |
| 0002A | <1% | 32 | $1K | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 18 | $360.00 |
| 80305 | <1% | 174 | $298.16 | |
| 91320 | <1% | 55 | $262.20 | |
| 90480 | <1% | 85 | $247.31 | |
| 90734 | <1% | 37 | $194.98 | |
| D1206 | Topical application of fluoride varnish | <1% | 15 | $180.00 |
| 90651 | <1% | 43 | $172.04 | |
| 0004A | <1% | 117 | $82.64 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 26 | $21.42 |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 51 | $19.42 |
| 83037 | <1% | 81 | $9.71 | |
| 87070 | <1% | 13 | $8.80 | |
| 81003 | <1% | 37 | $4.50 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 1,494 | $0.00 |
| 90715 | 0% | 67 | $0.00 | |
| 91300 | 0% | 167 | $0.00 | |
| 90633 | 0% | 128 | $0.00 | |
| 90671 | 0% | 70 | $0.00 | |
| 90648 | 0% | 12 | $0.00 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | 0% | 26 | $0.00 |
| 91312 | 0% | 93 | $0.00 | |
| 90681 | 0% | 12 | $0.00 | |
| 90662 | 0% | 29 | $0.00 | |
| 0071A | 0% | 16 | $0.00 | |
| 36416 | 0% | 430 | $0.00 | |
| 90698 | 0% | 12 | $0.00 | |
| 0072A | 0% | 26 | $0.00 | |
| 91305 | 0% | 79 | $0.00 | |
| 91319 | 0% | 12 | $0.00 | |
| 90697 | 0% | 13 | $0.00 | |
| 91307 | 0% | 62 | $0.00 | |
| 90619 | 0% | 13 | $0.00 | |
| 90474 | 0% | 12 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialINZANA, LUGENE (SVP FINANCE/CFO)
Parent organizationMAINEHEALTH
| Provider | Location | Paid |
|---|---|---|
| Mainehealth | Portland, ME | $142.72M |
| Mainehealth | Portland, ME | $115.05M |
| Mainehealth | Biddeford, ME | $70.83M |
| Mainehealth | Brunswick, ME | $40.06M |
| Mainehealth | Farmington, ME | $22.62M |
| Mainehealth | Biddeford, ME | $10.89M |
| Mainehealth | Falmouth, ME | $6.54M |
| Mainehealth | Portland, ME | $5.46M |
| Mainehealth | Scarborough, ME | $5.04M |
| Mainehealth | Rockport, ME | $4.34M |
| Mainehealth | Scarborough, ME | $4.16M |
| Mainehealth | Portland, ME | $4.09M |
| Mainehealth | Scarborough, ME | $3.94M |
| Mainehealth | Portland, ME | $3.55M |
| Mainehealth | Waldoboro, ME | $3.43M |
| Mainehealth | Scarborough, ME | $3.18M |
| Mainehealth | Brunswick, ME | $2.77M |
| Mainehealth | Portland, ME | $2.68M |
| Mainehealth | Falmouth, ME | $2.10M |
| Mainehealth | Portland, ME | $1.87M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.