Clinic
Mainehealth
Mainehealth was paid $16.71M by Medicaid between Feb 2020 and Dec 2024, across 97 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 90% of everything it billed.
33Billing provider infoMAINEHEALTH
FARMINGTON, ME 04938
FARMINGTON, ME 04938
33aNPI1245873082assigned 10/24/2019
33bProvider typeRural Health Clinic/Center
28Total paid$16.71M
24GClaims210,880
24DCodes billed97
24AFirst – last monthFeb 2020 – Dec 2024
Compared with peers
Next to other Rural Health Clinic/Center providers in Maine
Rank by total paid#1 of 22
Median peer was paid$1.81M
This provider vs. median9.2×
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 | |
|---|---|---|---|
| 2020 | 29,838 | $2.32M | |
| 2021 | 37,485 | $2.95M | |
| 2022 | 42,962 | $3.35M | |
| 2023 | 48,608 | $3.83M | |
| 2024incomplete | 51,987 | $4.26M |
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 | 90% | 67,958 | 54,303 | $15.08M |
| 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 | 3.5% | 29,235 | 26,057 | $582K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 2.7% | 24,926 | 22,304 | $452K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | <1% | 2,560 | 2,157 | $64K |
| G0008 | Administration of influenza virus vaccine | <1% | 4,157 | 4,116 | $58K |
| 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% | 2,863 | 2,787 | $57K |
| G2025 | Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only | <1% | 744 | 616 | $53K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 2,877 | 2,690 | $53K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | <1% | 2,237 | 2,194 | $45K |
| G0009 | Administration of pneumococcal vaccine | <1% | 2,203 | 2,154 | $26K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | <1% | 1,220 | 945 | $26K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | <1% | 787 | 779 | $21K |
85 more codes
| 90656 | <1% | 377 | $16K | |
| 20610 | <1% | 939 | $14K | |
| 11721 | <1% | 714 | $13K | |
| 90837 | Psychotherapy session, about an hour | <1% | 1,416 | $13K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 727 | $11K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | <1% | 1,040 | $11K |
| 90677 | <1% | 686 | $11K | |
| 91322 | <1% | 87 | $9K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 1,390 | $7K |
| 96127 | <1% | 3,012 | $7K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 5,810 | $6K |
| 90480 | <1% | 236 | $6K | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 3,820 | $6K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 479 | $5K |
| 90686 | <1% | 3,861 | $5K | |
| 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% | 1,021 | $5K |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 138 | $5K |
| 0124A | <1% | 122 | $4K | |
| 90715 | <1% | 1,600 | $4K | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 1,920 | $4K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | <1% | 2,661 | $3K |
| 36415 | Collection of venous blood by venipuncture | <1% | 2,365 | $3K |
| 90474 | <1% | 1,513 | $3K | |
| 0064A | <1% | 157 | $3K | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | <1% | 3,561 | $2K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 1,832 | $2K |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | <1% | 1,180 | $2K |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | <1% | 787 | $2K |
| 90619 | <1% | 495 | $2K | |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 738 | $1K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 43 | $1K |
| J1010 | Injection, methylprednisolone acetate, 1 mg | <1% | 186 | $946.55 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | <1% | 3,301 | $889.84 |
| 92583 | <1% | 625 | $838.50 | |
| 99495 | <1% | 12 | $827.61 | |
| 99205 | Prolong outpt/office vis | <1% | 107 | $817.76 |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 1,623 | $745.04 |
| 96160 | <1% | 1,086 | $744.78 | |
| D0191 | <1% | 61 | $734.12 | |
| 0072A | <1% | 35 | $665.64 | |
| 0134A | <1% | 15 | $554.70 | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 134 | $552.01 |
| 99188 | <1% | 1,183 | $540.06 | |
| D0145 | Oral evaluation for a patient under three years of age | <1% | 602 | $465.47 |
| 96161 | <1% | 1,006 | $464.65 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 106 | $418.42 |
| 69209 | <1% | 41 | $394.49 | |
| 96381 | <1% | 85 | $250.67 | |
| 90680 | <1% | 1,219 | $226.13 | |
| 90633 | <1% | 1,164 | $223.01 | |
| 0071A | <1% | 38 | $148.54 | |
| 99459 | <1% | 74 | $129.64 | |
| 90651 | <1% | 1,175 | $119.83 | |
| 99443 | <1% | 101 | $101.97 | |
| 36416 | <1% | 1,401 | $91.42 | |
| 99442 | <1% | 283 | $80.97 | |
| 0011A | <1% | 15 | $74.58 | |
| J1040 | Injection, methylprednisolone acetate, 80 mg | <1% | 17 | $62.90 |
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | <1% | 58 | $60.10 |
| 90833 | Psychotherapy, 30 minutes with patient when performed with an E&M service (add-on) | <1% | 19 | $46.02 |
| 99177 | <1% | 2,048 | $45.04 | |
| 90734 | <1% | 388 | $13.04 | |
| 99441 | <1% | 119 | $11.89 | |
| D1206 | Topical application of fluoride varnish | <1% | 831 | $1.14 |
| 90670 | 0% | 1,563 | $0.00 | |
| 90707 | 0% | 264 | $0.00 | |
| 90710 | 0% | 275 | $0.00 | |
| 90681 | 0% | 323 | $0.00 | |
| 90671 | 0% | 219 | $0.00 | |
| 91300 | 0% | 37 | $0.00 | |
| 90682 | 0% | 14 | $0.00 | |
| G2212 | Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or qualified healthcare professional, with or without direct patient contact (list separately in addition to cpt codes 99205, 99215, 99483 for office or other outpatient evaluation and management services) (do not report g2212 on the same date of service as 99358, 99359, 99415, 99416). (do not report g2212 for any time unit less than 15 minutes) | 0% | 17 | $0.00 |
| 90853 | Group psychotherapy (other than of a multiple-family group) | 0% | 32 | $0.00 |
| 98968 | 0% | 36 | $0.00 | |
| 90698 | 0% | 962 | $0.00 | |
| 90744 | 0% | 419 | $0.00 | |
| 90716 | 0% | 293 | $0.00 | |
| 90697 | 0% | 278 | $0.00 | |
| 90696 | 0% | 185 | $0.00 | |
| 90381 | 0% | 39 | $0.00 | |
| 92551 | 0% | 166 | $0.00 | |
| 99024 | 0% | 60 | $0.00 | |
| 90847 | Family psychotherapy with the patient present, 50 minutes | 0% | 13 | $0.00 |
| 91301 | 0% | 20 | $0.00 | |
| 0074A | 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 officialHUNTER, ROBERT (SENIOR VICE PRESIDENT FINANCE)
Parent organizationMAINEHEALTH
| Provider | Location | Paid |
|---|---|---|
| Mainehealth | Rockport, ME | $31.54M |
| Mainehealth | Norway, ME | $10.00M |
| 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.