Hospital
Mainehealth
Mainehealth was paid $5.04M by Medicaid between Jan 2018 and Dec 2023, across 131 billing codes. Its largest line is G0463, Hospital outpatient clinic visit for assessment and management of a patient — 67% of everything it billed.
33Billing provider infoMAINEHEALTH
SCARBOROUGH, ME 04074
SCARBOROUGH, ME 04074
33aNPI1497068969assigned 07/26/2010
33bProvider typeGeneral Acute Care Hospital
28Total paid$5.04M
24GClaims141,395
24DCodes billed131
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other General Acute Care Hospital providers in Maine
Rank by total paid#16 of 33
Median peer was paid$4.34M
This provider vs. median1.2×
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 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 | 1,974 | $93K | |
| 2019 | 2,969 | $103K | |
| 2020 | 19,004 | $659K | |
| 2021 | 46,287 | $1.42M | |
| 2022 | 36,660 | $1.40M | |
| 2023 | 34,501 | $1.37M |
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 | 67% | 46,558 | 40,111 | $3.36M |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | 2.9% | 8,082 | 7,454 | $146K |
| G0008 | Administration of influenza virus vaccine | 2.7% | 5,130 | 5,085 | $136K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 2.2% | 1,205 | 1,005 | $109K |
| 90677 | 2.2% | 562 | 556 | $109K | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | 2.0% | 3,856 | 3,733 | $101K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 2.0% | 1,615 | 1,450 | $100K |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 1.6% | 1,235 | 1,200 | $80K |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 1.6% | 1,246 | 1,194 | $80K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 1.5% | 1,187 | 1,174 | $75K |
| 0002A | 1.4% | 1,849 | 1,828 | $71K | |
| 90791 | Psychiatric diagnostic evaluationPsychiatric diagnostic evaluation | 1.4% | 726 | 714 | $69K |
119 more codes
| 0001A | 1.2% | 1,679 | $60K | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.2% | 939 | $59K |
| G0009 | Administration of pneumococcal vaccine | <1% | 1,744 | $48K |
| 90686 | <1% | 4,503 | $44K | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 617 | $41K |
| Q0222 | Injection, bebtelovimab, 175 mg | <1% | 30 | $34K |
| 90834 | Psychotherapy session, about 45 minutes | <1% | 364 | $26K |
| 97110 | Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion | <1% | 1,965 | $25K |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 980 | $23K |
| 90651 | <1% | 451 | $16K | |
| 97140 | Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) | <1% | 1,475 | $16K |
| 80061 | Lipid panel | <1% | 1,479 | $14K |
| 0124A | <1% | 861 | $14K | |
| 90732 | <1% | 256 | $11K | |
| M0243 | Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring | <1% | 39 | $11K |
| Q3014 | Telehealth originating site facility fee | <1% | 773 | $10K |
| 97810 | <1% | 598 | $9K | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 1,337 | $9K |
| 80053 | Comprehensive metabolic panel | <1% | 2,447 | $8K |
| 87591 | Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe | <1% | 1,111 | $8K |
| 87491 | Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe | <1% | 1,112 | $8K |
| 0054A | <1% | 427 | $8K | |
| 87624 | Infectious agent detection by nucleic acid; human papillomavirus (HPV), high-risk types | <1% | 726 | $7K |
| 90670 | <1% | 813 | $7K | |
| M0222 | Intravenous injection, bebtelovimab, includes injection and post administration monitoring | <1% | 47 | $7K |
| 80305 | <1% | 3,677 | $5K | |
| 87389 | Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies | <1% | 611 | $5K |
| 88142 | <1% | 501 | $4K | |
| 82306 | Vitamin D; 25 hydroxy, includes fraction(s), if performed | <1% | 286 | $4K |
| 87636 | Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B | <1% | 50 | $4K |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 1,755 | $4K |
| 90662 | <1% | 446 | $4K | |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 572 | $4K |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 1,556 | $4K |
| 86803 | <1% | 631 | $3K | |
| 36415 | Collection of venous blood by venipuncture | <1% | 4,327 | $3K |
| 90750 | <1% | 30 | $3K | |
| M0247 | Intravenous infusion, sotrovimab, includes infusion and post administration monitoring | <1% | 16 | $3K |
| 88175 | Cytopathology, cervical or vaginal, any reporting system; collected in preservative fluid, automated thin layer | <1% | 143 | $2K |
| 0031A | <1% | 67 | $2K | |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 498 | $2K |
| 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% | 32 | $2K |
| 91320 | <1% | 224 | $1K | |
| 82728 | <1% | 172 | $1K | |
| 98926 | <1% | 967 | $1K | |
| 97161 | <1% | 42 | $1K | |
| 87481 | <1% | 172 | $1K | |
| 86780 | <1% | 99 | $1K | |
| 83655 | <1% | 238 | $1K | |
| 97813 | <1% | 78 | $1K | |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 778 | $913.81 |
| G0010 | Administration of hepatitis b vaccine | <1% | 25 | $864.50 |
| 81025 | <1% | 829 | $828.16 | |
| 99188 | <1% | 36 | $828.00 | |
| 82607 | <1% | 106 | $742.28 | |
| 83550 | <1% | 148 | $729.20 | |
| 0012A | <1% | 48 | $705.60 | |
| 0052A | <1% | 31 | $690.30 | |
| 87511 | <1% | 92 | $679.82 | |
| 87661 | Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe | <1% | 93 | $636.32 |
| 85027 | <1% | 232 | $617.48 | |
| 82043 | <1% | 506 | $572.25 | |
| 83540 | <1% | 151 | $559.21 | |
| 90480 | <1% | 281 | $459.29 | |
| 0004A | <1% | 748 | $422.24 | |
| 98925 | <1% | 683 | $418.92 | |
| 87070 | <1% | 366 | $370.66 | |
| 85610 | <1% | 312 | $360.81 | |
| 0011A | <1% | 47 | $335.00 | |
| 82746 | <1% | 47 | $309.14 | |
| 90734 | <1% | 139 | $292.47 | |
| 98927 | <1% | 133 | $284.56 | |
| 87502 | Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets | <1% | 75 | $276.85 |
| 90619 | <1% | 67 | $260.00 | |
| 80307 | Drug test(s), presumptive, any number of drug classes; immunoassay | <1% | 15 | $224.45 |
| 81003 | <1% | 604 | $209.17 | |
| 90716 | <1% | 44 | $163.34 | |
| 83037 | <1% | 1,439 | $145.94 | |
| D1206 | Topical application of fluoride varnish | <1% | 12 | $144.00 |
| 90681 | <1% | 274 | $108.65 | |
| 90710 | <1% | 13 | $85.00 | |
| 81002 | <1% | 1,044 | $76.12 | |
| 85018 | <1% | 99 | $68.73 | |
| 87186 | <1% | 30 | $60.55 | |
| 90715 | <1% | 1,292 | $47.00 | |
| 84439 | <1% | 12 | $46.96 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 104 | $46.84 |
| 81001 | <1% | 83 | $44.58 | |
| 0064A | <1% | 121 | $40.50 | |
| 0072A | <1% | 174 | $40.50 | |
| 85652 | <1% | 43 | $37.80 | |
| 87077 | <1% | 30 | $37.38 | |
| 0003A | <1% | 22 | $34.58 | |
| 83735 | <1% | 13 | $33.50 | |
| 90744 | <1% | 148 | $16.00 | |
| 87210 | <1% | 19 | $8.72 | |
| J1030 | Injection, methylprednisolone acetate, 40 mg | <1% | 40 | $7.68 |
| 36416 | 0% | 2,639 | $0.00 | |
| 90698 | 0% | 345 | $0.00 | |
| 90696 | 0% | 17 | $0.00 | |
| 90474 | 0% | 283 | $0.00 | |
| 90697 | 0% | 200 | $0.00 | |
| 91306 | 0% | 104 | $0.00 | |
| 91305 | 0% | 366 | $0.00 | |
| 91307 | 0% | 277 | $0.00 | |
| G0145 | Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision | 0% | 81 | $0.00 |
| 91301 | 0% | 94 | $0.00 | |
| 91303 | 0% | 43 | $0.00 | |
| 90671 | 0% | 278 | $0.00 | |
| 90633 | 0% | 424 | $0.00 | |
| J1050 | Injection, medroxyprogesterone acetate, 1 mg | 0% | 437 | $0.00 |
| 90707 | 0% | 83 | $0.00 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | 0% | 1,980 | $0.00 |
| 91312 | 0% | 568 | $0.00 | |
| 0071A | 0% | 192 | $0.00 | |
| 91300 | 0% | 4,054 | $0.00 | |
| 87804 | Infectious agent antigen detection by immunoassay; Influenza, each type | 0% | 24 | $0.00 |
| 91321 | 0% | 32 | $0.00 | |
| 90700 | 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 officialINZANA, LUGENE (SVP FINANCE/CFO)
Parent organizationMAINE MEDICAL CENTER
| 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 | 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.