HOSPITAL ADMINISTRATIVE DISTRICT 4

NPI: 1508988627 · GUILFORD, ME 04443 · Family Medicine Physician · NPI assigned 04/06/2007

$171K

Total Medicaid Paid

3,202

Total Claims

2,778

Beneficiaries

Codes Billed

2018-01

First Month

2019-04

Last Month

Provider Details

Authorized Official	VIENNEAU, MARIE (PRESIDENT AND CEO)
Parent Organization	HOSPITAL ADMINISTRATIVE DISTRICT 4
NPI Enumeration Date	04/06/2007

Other providers sharing the same authorized official: VIENNEAU, MARIE

Provider	City	State	Total Paid
MRH CORP.	DOVER FOXCROFT	ME	$4.21M
MRH CORP.	MILO	ME	$1.86M
MRH CORP.	CORINTH	ME	$1.26M
EASTERN MAINE HEALTHCARE SYSTEMS	GREENVILLE	ME	$1.04M
MRH CORP.	DEXTER	ME	$663K
MRH CORP.	DEXTER	ME	$42K

Year	Claims	Total Paid
2018	2,825	$148K
2019	377	$23K

Code	Description	Claims	Beneficiaries	Total Paid
T1015	Clinic visit/encounter, all-inclusive	1,319	1,098	$148K
99214	Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	641	588	$13K
99213	Office or other outpatient visit for the evaluation and management of an established patient, low complexity	1,084	942	$8K
90471	Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine	59	59	$515.30
96127		38	37	$495.19
99212	Office or other outpatient visit for the evaluation and management of an established patient, straightforward	61	54	$222.09