Hospital
Mainehealth
Mainehealth was paid $4.34M by Medicaid between Jan 2019 and Dec 2024, across 70 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 31% of everything it billed.
33Billing provider infoMAINEHEALTH
ROCKPORT, ME 04856
ROCKPORT, ME 04856
33aNPI1578043378assigned 08/21/2018
33bProvider typeGeneral Acute Care Hospital
28Total paid$4.34M
24GClaims122,181
24DCodes billed70
24AFirst – last monthJan 2019 – Dec 2024
Compared with peers
Next to other General Acute Care Hospital providers in Maine
Rank by total paid#17 of 33
Median peer was paid$4.34M
This provider vs. median1.0×
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 | |
|---|---|---|---|
| 2019 | 20,078 | $556K | |
| 2020 | 12,776 | $384K | |
| 2021 | 17,047 | $521K | |
| 2022 | 20,135 | $723K | |
| 2023 | 25,088 | $1.08M | |
| 2024incomplete | 27,057 | $1.07M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 31% | 43,667 | 40,698 | $1.32M |
| 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 | 30% | 31,936 | 30,258 | $1.29M |
| 99284 | Emergency room visit (serious)Emergency department visit for the evaluation and management, high severity | 12% | 7,454 | 7,314 | $508K |
| 99285 | Emergency room visit (most serious)Emergency department visit for the evaluation and management, high severity with immediate threat to life | 4.4% | 2,149 | 2,070 | $192K |
| 99283 | Emergency room visit (moderate)Emergency department visit for the evaluation and management, moderate severity | 2.4% | 2,744 | 2,700 | $104K |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 2.3% | 1,809 | 1,782 | $98K |
| 90834 | Psychotherapy session, about 45 minutesPsychotherapy, 45 minutes with patient | 1.9% | 1,958 | 1,399 | $82K |
| 99232 | Hospital visit by a doctor, follow-up daySubsequent hospital care, per day, moderate complexity | 1.8% | 2,435 | 831 | $80K |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 1.7% | 1,401 | 1,295 | $72K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.6% | 2,136 | 1,479 | $71K |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 1.4% | 1,157 | 1,148 | $60K |
| 99215 | Doctor's office visit, returning patient (complex)Prolong outpt/office vis | 1.3% | 988 | 919 | $55K |
58 more codes
| 99203 | Doctor's office visit, new patient (routine) | <1% | 1,072 | $43K |
| 99282 | Emergency department visit for the evaluation and management, low to moderate severity | <1% | 1,566 | $37K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 1,637 | $33K |
| 93010 | Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only | <1% | 7,975 | $32K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | <1% | 327 | $24K |
| 99204 | Doctor's office visit, new patient (more involved) | <1% | 360 | $24K |
| 90847 | Family psychotherapy with the patient present, 50 minutes | <1% | 406 | $21K |
| 90792 | Psychiatric diagnostic evaluation with medical services | <1% | 261 | $20K |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | <1% | 245 | $14K |
| 95886 | <1% | 535 | $13K | |
| 99309 | Subsequent nursing facility care, per day, low to moderate complexity | <1% | 437 | $12K |
| 90837 | Psychotherapy session, about an hour | <1% | 180 | $12K |
| 99221 | <1% | 226 | $11K | |
| 99308 | Subsequent nursing facility care, per day, straightforward | <1% | 670 | $10K |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 519 | $9K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 93 | $9K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 298 | $6K |
| 11721 | <1% | 804 | $6K | |
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 72 | $5K |
| 99233 | Hospital visit by a doctor, follow-up day (complex) | <1% | 162 | $5K |
| G0399 | Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation | <1% | 155 | $5K |
| 99205 | Prolong outpt/office vis | <1% | 58 | $4K |
| 99223 | Prolong inpt eval add15 m | <1% | 58 | $4K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | <1% | 29 | $4K |
| 95908 | <1% | 103 | $3K | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 124 | $3K |
| 95910 | <1% | 43 | $3K | |
| 99443 | <1% | 110 | $3K | |
| 76816 | Ultrasound, pregnant uterus, real time with image documentation, follow-up | <1% | 93 | $2K |
| G0400 | Home sleep test (hst) with type iv portable monitor, unattended; minimum of 3 channels | <1% | 46 | $2K |
| 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% | 2,220 | $2K |
| 94060 | <1% | 263 | $2K | |
| 93306 | Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete | <1% | 67 | $2K |
| 11102 | <1% | 88 | $2K | |
| 76819 | Fetal biophysical profile; without non-stress testing | <1% | 75 | $2K |
| 20610 | <1% | 98 | $1K | |
| 98968 | <1% | 41 | $1K | |
| 99239 | Hospital discharge day management, more than 30 minutes | <1% | 39 | $1K |
| 99442 | <1% | 57 | $1K | |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 13 | $1K |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | <1% | 100 | $821.33 |
| 98928 | <1% | 28 | $814.19 | |
| 00731 | <1% | 31 | $763.50 | |
| 94729 | <1% | 182 | $729.74 | |
| 20553 | <1% | 30 | $707.31 | |
| 17110 | <1% | 30 | $522.32 | |
| 76830 | Ultrasound, transvaginal | <1% | 25 | $438.65 |
| 94726 | <1% | 89 | $387.55 | |
| 76815 | Ultrasound, pregnant uterus, real time with image documentation, limited | <1% | 18 | $353.76 |
| 11042 | Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm | <1% | 20 | $267.54 |
| 99188 | <1% | 18 | $261.16 | |
| 94727 | <1% | 41 | $241.88 | |
| 96127 | <1% | 41 | $131.44 | |
| 69210 | <1% | 14 | $116.61 | |
| 99441 | <1% | 15 | $110.18 | |
| 87880 | Infectious agent antigen detection by immunoassay; Streptococcus, group A | <1% | 13 | $81.97 |
| 73630 | <1% | 12 | $47.41 | |
| 94010 | <1% | 15 | $22.13 |
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)
| 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 | 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.