Hospital
Mainehealth
Mainehealth was paid $1.82M by Medicaid between Jan 2018 and Dec 2023, across 43 billing codes. Its largest line is G0463, Hospital outpatient clinic visit for assessment and management of a patient — 79% of everything it billed.
33Billing provider infoMAINEHEALTH
CAPE ELIZABETH, ME 04107
CAPE ELIZABETH, ME 04107
33aNPI1619281698assigned 08/02/2010
33bProvider typeGeneral Acute Care Hospital
28Total paid$1.82M
24GClaims52,576
24DCodes billed43
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other General Acute Care Hospital providers in Maine
Rank by total paid#21 of 33
Median peer was paid$4.34M
This provider vs. median0.4×
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 | 6,520 | $231K | |
| 2019 | 7,152 | $236K | |
| 2020 | 5,955 | $214K | |
| 2021 | 18,402 | $450K | |
| 2022 | 8,158 | $342K | |
| 2023 | 6,389 | $348K |
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 | 79% | 24,579 | 22,024 | $1.44M |
| 0002A | 3.8% | 3,376 | 3,375 | $69K | |
| 0001A | 3.6% | 3,468 | 3,466 | $65K | |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 2.8% | 940 | 875 | $52K |
| G0008 | Administration of influenza virus vaccine | 2.8% | 2,660 | 2,633 | $50K |
| 90832 | Psychotherapy session, about 30 minutesPsychotherapy, 30 minutes with patient | 1.8% | 368 | 279 | $32K |
| 90686 | 1.5% | 2,096 | 2,073 | $27K | |
| 90677 | 1.5% | 148 | 147 | $27K | |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | <1% | 288 | 264 | $16K |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 600 | 572 | $8K |
| G0009 | Administration of pneumococcal vaccine | <1% | 364 | 361 | $6K |
| 0124A | <1% | 366 | 357 | $5K |
31 more codes
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | <1% | 173 | $4K |
| 90662 | <1% | 448 | $3K | |
| Q3014 | Telehealth originating site facility fee | <1% | 227 | $3K |
| 90791 | Psychiatric diagnostic evaluation | <1% | 26 | $3K |
| 90732 | <1% | 72 | $2K | |
| 0054A | <1% | 163 | $2K | |
| 80305 | <1% | 1,308 | $2K | |
| 90853 | Group psychotherapy (other than of a multiple-family group) | <1% | 27 | $1K |
| 93005 | Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report | <1% | 299 | $1K |
| 0031A | <1% | 58 | $1K | |
| 83036 | Hemoglobin; glycosylated (A1C) | <1% | 868 | $697.87 |
| 80061 | Lipid panel | <1% | 82 | $578.47 |
| 80053 | Comprehensive metabolic panel | <1% | 194 | $287.14 |
| 91320 | <1% | 83 | $262.20 | |
| 82043 | <1% | 63 | $220.88 | |
| 84443 | Thyroid stimulating hormone (TSH) | <1% | 79 | $204.82 |
| 83037 | <1% | 1,645 | $193.07 | |
| 85025 | Blood count; complete (CBC), automated, and automated differential WBC count | <1% | 165 | $155.40 |
| 80048 | Basic metabolic panel (calcium, ionized) | <1% | 70 | $93.14 |
| 90480 | <1% | 83 | $70.66 | |
| 0004A | <1% | 222 | $67.80 | |
| 36415 | Collection of venous blood by venipuncture | <1% | 212 | $62.92 |
| 87086 | Culture, bacterial; quantitative colony count, urine | <1% | 12 | $16.50 |
| 81002 | <1% | 77 | $2.62 | |
| 91300 | 0% | 3,769 | $0.00 | |
| 91312 | 0% | 167 | $0.00 | |
| 90715 | 0% | 103 | $0.00 | |
| 36416 | 0% | 2,502 | $0.00 | |
| 91305 | 0% | 79 | $0.00 | |
| 91303 | 0% | 35 | $0.00 | |
| J3420 | Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg | 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 | 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 | 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 |
Matched on the authorized-official name exactly as entered in NPPES. A common name can match unrelated people.