NP / PA
Mainehealth
Mainehealth was paid $10.00M by Medicaid between Jan 2018 and Dec 2024, across 47 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 87% of everything it billed.
33Billing provider infoMAINEHEALTH
NORWAY, ME 04268
NORWAY, ME 04268
33aNPI1053601864assigned 04/13/2011
33bProvider typeFamily Nurse Practitioner
28Total paid$10.00M
24GClaims114,046
24DCodes billed47
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers
Next to other Family Nurse Practitioner providers in Maine
Rank by total paid#1 of 14
Median peer was paid$12K
This provider vs. median863×
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 HUNTER, ROBERT controls 13+ 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 | 15,335 | $936K | |
| 2019 | 19,782 | $1.06M | |
| 2020 | 12,466 | $1.30M | |
| 2021 | 15,088 | $1.54M | |
| 2022 | 14,395 | $1.45M | |
| 2023 | 17,888 | $1.76M | |
| 2024incomplete | 19,092 | $1.95M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 87% | 42,121 | 30,356 | $8.69M |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 6.5% | 27,115 | 24,163 | $653K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 4.1% | 23,641 | 19,801 | $410K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 2,966 | 1,837 | $41K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 545 | 406 | $28K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 926 | 893 | $25K |
| G0008 | Administration of influenza virus vaccine | <1% | 2,233 | 2,042 | $20K |
| 91322 | <1% | 168 | 148 | $18K | |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 704 | 625 | $13K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 1,461 | 1,450 | $12K |
| G2211 | Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) | <1% | 1,429 | 1,350 | $9K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | <1% | 410 | 219 | $8K |
35 more codes
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 1,811 | $8K |
| 90686 | <1% | 1,992 | $8K | |
| 90480 | <1% | 232 | $6K | |
| 0134A | <1% | 167 | $6K | |
| 90656 | <1% | 157 | $6K | |
| 90791 | Psychiatric diagnostic evaluation | <1% | 504 | $5K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 1,624 | $4K |
| 0064A | <1% | 199 | $4K | |
| 90677 | <1% | 56 | $4K | |
| 91320 | <1% | 53 | $3K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 397 | $2K |
| G0009 | Administration of pneumococcal vaccine | <1% | 209 | $2K |
| 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% | 210 | $2K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 60 | $2K |
| 99203 | Doctor's office visit, new patient (routine) | <1% | 158 | $1K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 1,359 | $1K |
| 90662 | <1% | 86 | $908.10 | |
| 90837 | Psychotherapy session, about an hour | <1% | 67 | $655.20 |
| G0438 | Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit | <1% | 43 | $559.44 |
| 92229 | <1% | 20 | $408.36 | |
| 96127 | <1% | 13 | $322.97 | |
| 99442 | <1% | 185 | $273.40 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 30 | $223.83 |
| 36416 | <1% | 26 | $203.01 | |
| G0071 | Payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an rural health clinic (rhc) or federally qualified health center (fqhc) practitioner and rhc or fqhc patient, or 5 minutes or more of remote evaluation of recorded video and/or images by an rhc or fqhc practitioner, occurring in lieu of an office visit; rhc or fqhc only | <1% | 53 | $137.86 |
| 90715 | <1% | 223 | $111.83 | |
| 0011A | <1% | 30 | $74.58 | |
| 0012A | <1% | 65 | $73.96 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 31 | $0.00 |
| 90633 | 0% | 12 | $0.00 | |
| 90734 | 0% | 14 | $0.00 | |
| 69209 | 0% | 15 | $0.00 | |
| 91301 | 0% | 202 | $0.00 | |
| 99443 | 0% | 12 | $0.00 | |
| 99441 | 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 officialHUNTER, ROBERT (SENIOR VICE PRESIDENT)
Parent organizationMAINEHEALTH
| Provider | Location | Paid |
|---|---|---|
| Mainehealth | Rockport, ME | $31.54M |
| Mainehealth | Farmington, ME | $16.71M |
| Mainehealth | Norway, ME | $9.84M |
| Mainehealth | Damariscotta, ME | $9.60M |
| Mainehealth | Belfast, ME | $5.33M |
| Mainehealth | Norway, ME | $5.06M |
| Mainehealth | Livermore Falls, ME | $3.15M |
| Mainehealth | Boothbay Harbor, ME | $2.90M |
| Mainehealth | Damariscotta, ME | $2.62M |
| Mainehealth | Farmington, ME | $2.36M |
| University Pathologists | Houston, TX | $1.35M |
| Mainehealth | Farmington, ME | $435K |
| P R Hematology Oncology Group INC | Bayamon, PR | $69K |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.