Behavioral
Mainehealth
Mainehealth was paid $3.55M by Medicaid between Jan 2018 and Dec 2023, across 45 billing codes. Its largest line is G0463, Hospital outpatient clinic visit for assessment and management of a patient — 90% of everything it billed.
33Billing provider infoMAINEHEALTH
PORTLAND, ME 04102
PORTLAND, ME 04102
33aNPI1477850592assigned 02/25/2011
33bProvider typeClinical Social Worker
28Total paid$3.55M
24GClaims52,301
24DCodes billed45
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other Clinical Social Worker providers in Maine
Rank by total paid#9 of 82
Median peer was paid$33K
This provider vs. median106×
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 | 10,286 | $677K | |
| 2019 | 10,475 | $665K | |
| 2020 | 7,847 | $442K | |
| 2021 | 6,828 | $534K | |
| 2022 | 8,226 | $624K | |
| 2023 | 8,639 | $611K |
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 | 90% | 34,726 | 32,117 | $3.21M |
| 96152 | 1.8% | 564 | 432 | $65K | |
| G0108 | Diabetes outpatient self-management training services, individual, per 30 minutes | 1.7% | 1,577 | 1,435 | $59K |
| 97803 | 1.5% | 1,636 | 1,554 | $54K | |
| G0008 | Administration of influenza virus vaccine | <1% | 1,077 | 1,004 | $33K |
| Q3014 | Telehealth originating site facility fee | <1% | 1,852 | 1,764 | $29K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 448 | 437 | $21K |
| 96150 | <1% | 161 | 155 | $18K | |
| 97802 | <1% | 417 | 414 | $17K | |
| 96158 | <1% | 188 | 129 | $11K | |
| 96154 | <1% | 68 | 56 | $6K | |
| 94010 | <1% | 704 | 675 | $6K |
33 more codes
| 96101 | <1% | 25 | $4K | |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 27 | $3K |
| 90837 | Psychotherapy session, about an hour | <1% | 31 | $3K |
| 96130 | <1% | 13 | $3K | |
| 90734 | <1% | 26 | $3K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 753 | $2K |
| S9441 | Asthma education, non-physician provider, per session | <1% | 107 | $2K |
| 96136 | <1% | 25 | $1K | |
| 83037 | <1% | 1,351 | $485.50 | |
| 90686 | <1% | 1,074 | $449.00 | |
| 0054A | <1% | 13 | $405.00 | |
| 96127 | <1% | 1,090 | $244.83 | |
| 96167 | <1% | 20 | $234.30 | |
| 99401 | <1% | 33 | $196.80 | |
| 87070 | <1% | 99 | $113.50 | |
| 87077 | <1% | 69 | $90.78 | |
| 87186 | <1% | 30 | $43.97 | |
| 81002 | <1% | 736 | $2.62 | |
| 81003 | <1% | 78 | $2.30 | |
| 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% | 58 | $0.00 |
| 90691 | 0% | 452 | $0.00 | |
| 96159 | 0% | 121 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 218 | $0.00 |
| 91300 | 0% | 12 | $0.00 | |
| 94664 | 0% | 12 | $0.00 | |
| 96137 | 0% | 25 | $0.00 | |
| 91312 | 0% | 13 | $0.00 | |
| 0124A | 0% | 13 | $0.00 | |
| 36416 | 0% | 2,121 | $0.00 | |
| 90717 | 0% | 175 | $0.00 | |
| 96131 | 0% | 13 | $0.00 | |
| 91305 | 0% | 33 | $0.00 | |
| 91307 | 0% | 17 | $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 (ASSOCIATE 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 | 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.