Clinic
Mainehealth
Mainehealth was paid $10.89M by Medicaid between Jan 2019 and May 2024, across 116 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 28% of everything it billed.
33Billing provider infoMAINEHEALTH
BIDDEFORD, ME 04005
BIDDEFORD, ME 04005
33aNPI1215417019assigned 08/21/2018
33bProvider typeUrgent Care Clinic/Center
28Total paid$10.89M
24GClaims344,236
24DCodes billed116
24AFirst – last monthJan 2019 – May 2024
Compared with peers
Next to other Urgent Care Clinic/Center providers in Maine
Rank by total paid#1 of 28
Median peer was paid$297K
This provider vs. median37×
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 | |
|---|---|---|---|
| 2019 | 67,837 | $1.84M | |
| 2020 | 45,858 | $1.31M | |
| 2021 | 63,404 | $1.77M | |
| 2022 | 64,432 | $2.07M | |
| 2023 | 70,071 | $2.67M | |
| 2024incomplete | 32,634 | $1.23M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 28% | 104,898 | 99,748 | $3.03M |
| 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 | 24% | 79,003 | 75,594 | $2.65M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 13% | 22,228 | 21,822 | $1.43M |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 4.7% | 5,805 | 5,660 | $516K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 3.7% | 11,488 | 11,274 | $404K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 3.1% | 11,999 | 3,924 | $334K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.5% | 5,011 | 4,949 | $271K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.1% | 4,334 | 4,220 | $229K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.9% | 3,790 | 3,753 | $206K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 1.6% | 4,546 | 4,446 | $171K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | 1.3% | 32,983 | 26,902 | $144K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | 1.1% | 5,022 | 4,932 | $115K |
104 more codes
| 90832 | Psychotherapy session, about 30 minutes | 1.0% | 4,458 | $113K |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | 1.0% | 4,463 | $110K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 2,682 | $95K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 1,629 | $82K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 4,479 | $75K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 1,725 | $60K |
| 64493 | <1% | 1,621 | $60K | |
| 99223 | Prolong inpt eval add15 m | <1% | 731 | $60K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 892 | $50K |
| 98928 | <1% | 1,586 | $44K | |
| 64494 | <1% | 2,093 | $40K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 846 | $34K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 486 | $33K |
| 20610 | <1% | 1,727 | $31K | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 1,284 | $28K |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 1,261 | $28K |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 1,087 | $27K |
| 64495 | <1% | 1,194 | $27K | |
| 98929 | <1% | 980 | $27K | |
| 99215 | Doctor's office visit, returning patient (complex) | <1% | 497 | $26K |
| 99205 | Prolong outpt/office vis | <1% | 235 | $19K |
| 90870 | <1% | 520 | $19K | |
| 27096 | <1% | 590 | $18K | |
| 96158 | <1% | 581 | $18K | |
| 97803 | <1% | 706 | $17K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 289 | $17K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 242 | $17K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 269 | $13K |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 264 | $11K |
| 99443 | <1% | 343 | $9K | |
| 98927 | <1% | 432 | $9K | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 150 | $9K |
| 20611 | <1% | 420 | $9K | |
| 64635 | <1% | 105 | $8K | |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 445 | $8K |
| 95886 | <1% | 235 | $8K | |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 54 | $8K |
| 64615 | <1% | 166 | $7K | |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | <1% | 229 | $7K |
| 92551 | <1% | 554 | $6K | |
| 99234 | <1% | 108 | $6K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 225 | $6K |
| 64636 | <1% | 171 | $5K | |
| 99221 | <1% | 136 | $5K | |
| 95810 | Polysomnography; sleep staging with 4 or more additional parameters | <1% | 95 | $5K |
| 99442 | <1% | 343 | $5K | |
| 76817 | Ultrasound, pregnant uterus, real time with image documentation, transvaginal | <1% | 203 | $4K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 42 | $4K |
| 96132 | <1% | 68 | $4K | |
| 51798 | <1% | 1,065 | $4K | |
| 73600 | <1% | 878 | $4K | |
| 73630 | <1% | 831 | $3K | |
| 99173 | <1% | 694 | $3K | |
| 96139 | <1% | 32 | $3K | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 471 | $2K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 284 | $2K |
| 73562 | <1% | 577 | $2K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 38 | $2K |
| 99238 | Hospital discharge day management, 30 minutes or less | <1% | 54 | $2K |
| 76805 | Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation | <1% | 52 | $2K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 26 | $2K |
| 96127 | <1% | 566 | $2K | |
| 64490 | <1% | 43 | $1K | |
| 97597 | <1% | 205 | $1K | |
| 99459 | <1% | 91 | $1K | |
| 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% | 1,058 | $961.39 |
| 64491 | <1% | 49 | $960.59 | |
| 99441 | <1% | 129 | $877.03 | |
| 62323 | <1% | 25 | $859.75 | |
| 99291 | Critical care, evaluation and management of the critically ill patient, first 30-74 minutes | <1% | 30 | $798.68 |
| 00104 | <1% | 23 | $754.47 | |
| 95811 | <1% | 14 | $645.98 | |
| 96138 | <1% | 32 | $613.39 | |
| 94060 | <1% | 92 | $594.66 | |
| 94660 | <1% | 41 | $549.50 | |
| 43235 | <1% | 12 | $547.31 | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 46 | $545.58 |
| 81003 | <1% | 458 | $520.59 | |
| 64492 | <1% | 30 | $457.09 | |
| 93350 | <1% | 12 | $398.39 | |
| 98967 | <1% | 18 | $393.72 | |
| 0001A | <1% | 13 | $372.90 | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 52 | $324.01 |
| 73030 | <1% | 80 | $287.30 | |
| 93018 | <1% | 46 | $259.43 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | <1% | 62 | $224.26 |
| 93016 | <1% | 25 | $218.44 | |
| 29581 | <1% | 18 | $192.40 | |
| 94729 | <1% | 24 | $150.54 | |
| 93227 | <1% | 13 | $138.22 | |
| 98968 | <1% | 15 | $136.95 | |
| 93325 | <1% | 70 | $114.17 | |
| 94726 | <1% | 13 | $99.72 | |
| 73100 | <1% | 13 | $69.00 | |
| 73620 | <1% | 14 | $51.35 | |
| 93321 | <1% | 15 | $50.90 | |
| 81000 | <1% | 335 | $46.35 | |
| 94010 | <1% | 12 | $45.69 | |
| G0500 | Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient's level of consciousness and physiological status; initial 15 minutes of intra-service time; patient age 5 years or older (additional time may be reported with 99153, as appropriate) | <1% | 215 | $29.96 |
| 81001 | <1% | 93 | $1.26 | |
| G2012 | Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion | 0% | 12 | $0.00 |
| 90686 | 0% | 23 | $0.00 | |
| 97804 | 0% | 36 | $0.00 | |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 0% | 13 | $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 (SENIOR VICE PRESIDENT FINANCE & CFO)
| 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 | 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 |
| Mainehealth | Cape Elizabeth, ME | $1.82M |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.