Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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Hospital

Sebasticook Valley Health

Sebasticook Valley Health was paid $3.69M by Medicaid between Jan 2018 and Dec 2024, across 271 billing codes. Its largest line is 99285, emergency room visit (most serious) — 9.3% of everything it billed.

33Billing provider infoSEBASTICOOK VALLEY HEALTH
PITTSFIELD, ME 04967
33aNPI1457461477assigned 08/30/2006
33bProvider typeCritical Access Hospital
28Total paid$3.69M
24GClaims570,181
24DCodes billed271
24AFirst – last monthJan 2018 – Dec 2024
Compared with peers

Next to other Critical Access Hospital providers in Maine

Rank by total paid#4 of 14
Median peer was paid$1.76M
This provider vs. median2.1×

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.

Box 24A · Dates of service

Paid by month

$0$25K$50K$75K2018201920202021202220232024
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
YearClaimsPaid
201865,687$514K
201970,946$544K
202073,204$426K
202192,058$520K
202290,879$558K
202397,102$564K
2024incomplete80,305$559K
Box 24 · Service lines

What it billed for

CodeServiceShareClaimsBene. recordsPaid
99285 Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life 9.3% 7,218 6,300 $341K
74177 Computed tomography, abdomen and pelvis; with contrast material 7.2% 2,248 1,729 $264K
99284 Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity 6.1% 10,710 9,341 $227K
93306 Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete 5.7% 2,582 1,397 $210K
70450 Computed tomography, head or brain; without contrast material 4.8% 2,609 1,985 $177K
99283 Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity 4.8% 16,998 14,432 $177K
74176 Computed tomography, abdomen and pelvis; without contrast material 4.4% 1,709 1,294 $161K
G0378 Hospital observation service, per hour 3.8% 1,552 1,239 $142K
99213 Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity 3.2% 27,155 19,219 $119K
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 2.7% 16,029 11,405 $98K
96361 Intravenous infusion, hydration; each additional hour 2.6% 3,226 1,918 $97K
71046 Radiologic examination, chest; 2 views 2.6% 7,451 5,817 $97K
259 more codes
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report 2.5% 9,905 $94K
97110 Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion 2.5% 16,950 $91K
99212 Office or other outpatient visit for the evaluation and management of an established patient, straightforward 2.1% 26,724 $79K
A0427 Emergency ambulance ride, advanced life support 1.8% 2,052 $65K
80053 Comprehensive metabolic panel 1.5% 29,929 $56K
78452 Myocardial perfusion imaging, tomographic (SPECT); multiple studies at rest and/or stress 1.4% 709 $50K
73630 1.3% 3,354 $49K
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour 1.3% 4,397 $48K
97140 Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) 1.2% 11,156 $44K
96372 Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular 1.1% 5,955 $40K
72148 Magnetic resonance imaging, lumbar spine; without contrast material 1.1% 654 $39K
94762 1.0% 996 $38K
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance 1.0% 5,770 $37K
11721 1.0% 5,907 $37K
A0429 Emergency ambulance ride, basic life support <1% 1,421 $36K
99282 Emergency department visit for the evaluation and management, low to moderate severity <1% 5,123 $35K
71250 <1% 485 $35K
A0425 Ground mileage, per statute mile <1% 4,747 $32K
93017 <1% 643 $28K
73562 <1% 1,588 $26K
71045 Radiologic examination, chest; single view <1% 2,743 $22K
99203 Doctor's office visit, new patient (routine) <1% 4,616 $22K
72100 <1% 1,308 $21K
96375 Therapeutic injection; each additional sequential IV push <1% 5,001 $20K
73030 <1% 1,364 $20K
73721 Magnetic resonance imaging, any joint of lower extremity; without contrast material <1% 356 $18K
70551 Magnetic resonance imaging, brain; without contrast material <1% 401 $18K
85025 Blood count; complete (CBC), automated, and automated differential WBC count <1% 30,461 $18K
84443 Thyroid stimulating hormone (TSH) <1% 11,452 $18K
J2704 Injection, propofol, 10 mg <1% 3,489 $16K
71275 Computed tomographic angiography, chest, with contrast material <1% 175 $15K
94760 <1% 2,737 $15K
A9502 Technetium tc-99m tetrofosmin, diagnostic, per study dose <1% 378 $15K
99215 Doctor's office visit, returning patient (complex) <1% 1,797 $13K
96366 Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour <1% 1,428 $13K
Q9965 Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml <1% 1,076 $12K
97161 <1% 1,231 $12K
83036 Hemoglobin; glycosylated (A1C) <1% 9,250 $12K
88305 Level IV - Surgical pathology, gross and microscopic examination <1% 702 $11K
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml <1% 1,869 $11K
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction <1% 800 $11K
73610 <1% 1,070 $10K
99204 Doctor's office visit, new patient (more involved) <1% 1,677 $10K
76705 Ultrasound, abdominal, real time with image documentation; limited <1% 481 $9K
96376 <1% 2,197 $9K
73130 <1% 767 $8K
36415 Collection of venous blood by venipuncture <1% 42,725 $8K
84484 <1% 6,671 $8K
97162 <1% 703 $8K
80061 Lipid panel <1% 10,329 $8K
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed <1% 3,935 $8K
83735 <1% 11,788 $8K
J0696 Injection, ceftriaxone sodium, per 250 mg <1% 1,592 $7K
97035 <1% 2,666 $7K
73502 <1% 395 $6K
J2405 Injection, ondansetron hydrochloride, per 1 mg <1% 4,559 $6K
80048 Basic metabolic panel (calcium, ionized) <1% 5,302 $5K
87636 Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B <1% 6,514 $5K
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only <1% 9,811 $5K
J3475 Injection, magnesium sulfate, per 500 mg <1% 1,631 $5K
82043 <1% 2,068 $5K
J0131 Injection, acetaminophen, not otherwise specified,10 mg <1% 921 $4K
82728 <1% 2,493 $4K
83880 <1% 1,555 $4K
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour <1% 403 $3K
82607 <1% 2,451 $3K
85027 <1% 3,976 $3K
81001 <1% 5,380 $3K
J2785 Injection, regadenoson, 0.1 mg <1% 113 $3K
72125 Computed tomography, cervical spine; without contrast material <1% 90 $3K
84439 <1% 2,517 $3K
87077 <1% 2,638 $3K
83550 <1% 2,197 $3K
99281 Emergency department visit for the evaluation and management, self-limited or minor <1% 532 $3K
J3010 Injection, fentanyl citrate, 0.1 mg <1% 2,529 $3K
87086 Culture, bacterial; quantitative colony count, urine <1% 3,773 $3K
97112 Therapeutic procedure, each 15 minutes; neuromuscular reeducation of movement, balance, coordination <1% 750 $3K
99202 Office or other outpatient visit for the evaluation and management of a new patient, straightforward <1% 628 $3K
80307 Drug test(s), presumptive, any number of drug classes; immunoassay <1% 1,141 $3K
G0480 Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 1-7 drug class(es), including metabolite(s) if performed <1% 1,463 $3K
86140 <1% 3,209 $2K
A0428 Ambulance service, basic life support, non-emergency transport, (bls) <1% 176 $2K
76830 Ultrasound, transvaginal <1% 136 $2K
71271 <1% 353 $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% 1,770 $2K
71260 Computed tomography, thorax, diagnostic; with contrast material <1% 47 $2K
83690 <1% 3,870 $2K
C8929 Transthoracic echocardiography with contrast, or without contrast followed by with contrast, real-time with image documentation (2d), includes m-mode recording, when performed, complete, with spectral doppler echocardiography, and with color flow doppler echocardiography <1% 12 $2K
81003 <1% 6,017 $2K
93971 <1% 75 $2K
83540 <1% 2,365 $2K
93242 <1% 43 $2K
J1885 Injection, ketorolac tromethamine, per 15 mg <1% 5,929 $2K
82570 <1% 815 $2K
87186 <1% 1,521 $2K
J1040 Injection, methylprednisolone acetate, 80 mg <1% 373 $1K
85610 <1% 5,062 $1K
96367 <1% 321 $1K
Q3014 Telehealth originating site facility fee <1% 923 $1K
J1030 Injection, methylprednisolone acetate, 40 mg <1% 444 $1K
82248 <1% 1,350 $1K
99211 Office or other outpatient visit for the evaluation and management of an established patient, minimal severity <1% 1,143 $1K
83605 <1% 2,198 $1K
99291 Critical care, evaluation and management of the critically ill patient, first 30-74 minutes <1% 13 $1K
85651 <1% 2,268 $1K
87040 <1% 1,073 $1K
99442 <1% 84 $1K
87798 Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism <1% 60 $983.43
J2250 Injection, midazolam hydrochloride, per 1 mg <1% 1,655 $975.51
84153 <1% 243 $947.49
72141 <1% 13 $944.00
98929 <1% 110 $889.95
J1010 Injection, methylprednisolone acetate, 1 mg <1% 130 $874.03
99443 <1% 44 $873.08
U0004 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r <1% 2,476 $845.00
J1815 Injection, insulin, per 5 units <1% 399 $791.47
J1650 Injection, enoxaparin sodium, 10 mg <1% 122 $788.60
93016 <1% 588 $768.27
J0690 Injection, cefazolin sodium, 500 mg <1% 246 $744.75
90715 <1% 444 $686.01
82746 <1% 420 $683.14
87631 <1% 459 $676.91
97165 <1% 57 $656.29
93225 <1% 14 $653.00
80305 <1% 1,033 $583.82
93018 <1% 588 $582.33
76376 <1% 54 $554.84
90471 Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine <1% 1,836 $550.81
J2270 Injection, morphine sulfate, up to 10 mg <1% 617 $527.03
77080 <1% 200 $525.88
L4361 Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf <1% 45 $522.05
J0665 Injection, bupivicaine, not otherwise specified, 0.5 mg <1% 177 $505.82
85379 <1% 879 $500.38
95886 <1% 59 $490.23
86618 <1% 539 $479.97
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit <1% 490 $472.58
J2930 Injection, methylprednisolone sodium succinate, up to 125 mg <1% 351 $469.19
J3370 Injection, vancomycin hcl, 500 mg <1% 64 $435.49
80076 <1% 172 $433.25
80306 <1% 1,093 $417.09
01480 <1% 14 $413.93
77067 Screening mammography, bilateral, including computer-aided detection <1% 2,883 $366.23
82803 <1% 490 $350.50
87651 Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe <1% 860 $346.70
99220 <1% 26 $315.80
20610 <1% 50 $287.39
87205 <1% 1,070 $277.00
83970 <1% 76 $268.57
82077 <1% 582 $257.39
J1100 Injection, dexamethasone sodium phosphate, 1 mg <1% 2,178 $255.80
G0008 Administration of influenza virus vaccine <1% 1,055 $228.53
97530 Therapeutic activities, direct patient contact, each 15 minutes <1% 111 $219.79
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc <1% 471 $218.25
82565 <1% 552 $217.18
43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple <1% 24 $216.93
84100 <1% 302 $207.88
95911 <1% 12 $207.68
76536 <1% 26 $204.55
99217 <1% 46 $197.73
87468 <1% 79 $191.75
93226 <1% 14 $182.00
U0003 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r <1% 593 $172.64
86850 <1% 31 $163.44
97166 <1% 14 $160.10
86803 <1% 235 $158.05
U0005 Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 <1% 1,698 $156.14
77063 Screening digital breast tomosynthesis, bilateral <1% 2,728 $152.40
00812 <1% 14 $151.05
81025 <1% 3,260 $145.93
85730 <1% 361 $138.40
73600 <1% 29 $130.94
76642 <1% 14 $122.28
C9113 Injection, pantoprazole sodium, per vial <1% 98 $120.95
J2920 Injection, methylprednisolone sodium succinate, up to 40 mg <1% 24 $114.46
J1200 Injection, diphenhydramine hcl, up to 50 mg <1% 261 $110.06
J0692 Injection, cefepime hydrochloride, 500 mg <1% 25 $108.23
82330 <1% 361 $105.35
J2060 Injection, lorazepam, 2 mg <1% 248 $105.23
90686 <1% 1,176 $105.08
87491 Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe <1% 816 $104.65
A9270 Non-covered item or service <1% 1,397 $88.37
87591 Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe <1% 810 $87.63
90662 <1% 50 $83.75
73110 <1% 17 $80.87
87484 <1% 79 $76.79
J1170 Injection, hydromorphone, up to 4 mg <1% 186 $63.48
J0736 Injection, clindamycin phosphate, 300 mg <1% 18 $62.89
86901 <1% 59 $61.27
86900 <1% 31 $59.99
87478 <1% 32 $59.55
87635 Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe <1% 70 $59.44
82435 <1% 357 $54.97
84132 <1% 464 $52.01
87502 Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets <1% 214 $48.87
99396 Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years <1% 1,180 $48.09
87661 Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe <1% 288 $47.23
P9604 Travel allowance one way in connection with medically necessary laboratory specimen collection drawn from home bound or nursing home bound patient; prorated trip charge <1% 786 $45.81
87469 <1% 63 $45.20
84550 <1% 54 $42.84
J1644 Injection, heparin sodium, per 1000 units <1% 90 $42.43
80143 <1% 55 $39.95
84520 <1% 360 $39.90
84295 <1% 363 $39.05
J2765 Injection, metoclopramide hcl, up to 10 mg <1% 133 $33.01
J3480 Injection, potassium chloride, per 2 meq <1% 32 $32.06
87081 <1% 659 $31.81
Q0162 Ondansetron 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen <1% 1,175 $29.57
G0103 Prostate cancer screening; prostate specific antigen test (psa) <1% 127 $27.98
93244 <1% 43 $24.70
93227 <1% 14 $21.91
J7512 Prednisone, immediate release or delayed release, oral, 1 mg <1% 805 $17.43
87340 <1% 13 $16.82
J2003 Injection, lidocaine hydrochloride, 1 mg <1% 65 $16.80
99397 <1% 32 $16.79
82550 <1% 31 $16.15
86430 <1% 30 $14.03
84703 <1% 57 $13.94
87804 Infectious agent antigen detection by immunoassay; Influenza, each type <1% 284 $12.66
L3908 Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf <1% 13 $10.84
0124A <1% 28 $10.71
84702 <1% 67 $10.59
85014 <1% 26 $10.23
82947 <1% 464 $9.41
86706 <1% 14 $9.37
80179 <1% 28 $7.20
J2001 Injection, lidocaine hcl for intravenous infusion, 10 mg <1% 33 $6.20
J2004 Injection, lidocaine hcl with epinephrine, 1 mg <1% 13 $5.11
99395 Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years <1% 815 $4.82
87390 <1% 13 $3.14
84600 <1% 101 $2.81
90472 Immunization administration, each additional vaccine (list separately) <1% 89 $2.60
86702 <1% 13 $2.21
86701 <1% 13 $2.21
85018 <1% 14 $2.15
81002 <1% 188 $1.80
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme <1% 866 $0.66
G8979 Mobility: walking & moving around functional limitation, projected goal status, at therapy episode outset, at reporting intervals, and at discharge or to end reporting <1% 211 $0.12
G8978 Mobility: walking & moving around functional limitation, current status, at therapy episode outset and at reporting intervals <1% 104 $0.05
87880 Infectious agent antigen detection by immunoassay; Streptococcus, group A 0% 710 $0.00
99393 Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) 0% 22 $0.00
00170 Anesthesia for intraoral procedures, including biopsy 0% 655 $0.00
0002A 0% 13 $0.00
91300 0% 42 $0.00
J2919 Injection, methylprednisolone sodium succinate, 5 mg 0% 14 $0.00
99394 Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) 0% 27 $0.00
U0001 Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel 0% 20 $0.00
72070 0% 12 $0.00
86038 0% 34 $0.00
73140 0% 27 $0.00
41899 Unlisted procedure, dentoalveolar structures 0% 665 $0.00
M0243 Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring 0% 42 $0.00
J7613 Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg 0% 66 $0.00
0012A 0% 359 $0.00
91301 0% 207 $0.00
90656 0% 34 $0.00
0011A 0% 354 $0.00
87637 Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV 0% 14 $0.00
0001A 0% 24 $0.00
88142 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 officialCLARK, RANDALL (VP OF FINANCE)
Same official

Other billing entities under CLARK, RANDALL

Full network →
ProviderLocationPaid
MRH Corp.Dover Foxcroft, ME$3.71M
Sebasticook Valley HealthPittsfield, ME$2.82M
Sebasticook Valley HealthUnity, ME$1.39M
Sebasticook Valley HealthNewport, ME$1.33M
Charles a Dean Memorial HospitalGreenville, ME$617K
Belle Meade Foundation INCRichmond, MI$172K
Riverwood Family Medicine PCGrand Rapids, MI$12K

Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.