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Mainehealth

Emergency Medicine·Portland, ME·NPI: 1760436216Share

Compared to Emergency Medicine Peers

Total spending distribution among 11 providers in this specialty

P25MedianP75P90

This provider's total spending of $142.7M is at the 90th percentile among 11 Emergency Medicine providers.

Above 90th percentile for this specialty — higher spending than 9 of 11 peers

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$142.7M

$142,715,239

Total Claims

3.0M

Beneficiaries

2.5M

1.2 claims/patient

Avg Cost/Claim

$47

#771 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Mainehealth is a Emergency Medicine provider based in Portland, ME. From the 2018–2024 period, this provider received $142.7M in Medicaid payments across 3.0M claims.

Why This Matters

This provider received $142.7M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 17,839 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 281% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$11.5M
+19%
2019
$13.7M
-9%
2020
$12.4M
+47%
2021
$18.3M
+7%
2022
$19.4M
+20%
2023
$23.3M
+89%
2024
$44.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0463 (Hospital outpatient clinic visit)) accounts for 16% of total spending.

G0463Top 25%

Hospital outpatient clinic visit

$22.7M

319K claims · 15.9%

Your Cost: $71.29/claim|Median: $26.41
2.7× median
99284Top 25%

Emergency dept visit, high complexity

$16.6M

105K claims · 11.6%

Your Cost: $157.72/claim|Median: $69.51
2.3× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$14.1M

54K claims · 9.9%

Your Cost: $261.72/claim|Median: $85.65
3.1× median
J9271Normal range

Injection, pembrolizumab, 1 mg

$5.5M

825 claims · 3.9%

Your Cost: $6,701.93/claim|Median: $5,391.55
1.2× median
99283Top 25%

Emergency dept visit, moderate complexity

$4.7M

41K claims · 3.3%

Your Cost: $112.23/claim|Median: $42.48
2.6× median
J1459Normal range

$2.8M

3K claims · 2.0%

Your Cost: $923.53/claim|Median: $949.14
1.0× median
96374Top 10%

Therapeutic/prophylactic/diagnostic IV push, single substance

$2.6M

25K claims · 1.8%

Your Cost: $103.35/claim|Median: $21.76
4.8× median
77386Normal range

Intensity modulated radiation treatment delivery, complex

$2.6M

11K claims · 1.8%

Your Cost: $233.42/claim|Median: $260.56
0.9× median
J1745Normal range

Injection, infliximab, excludes biosimilar, 10 mg

$2.5M

1K claims · 1.7%

Your Cost: $2,081.56/claim|Median: $1,587.53
1.3× median
G0383Top 25%

$2.4M

15K claims · 1.7%

Your Cost: $159.94/claim|Median: $108.78
1.5× median
G0382Top 25%

$2.1M

17K claims · 1.5%

Your Cost: $125.98/claim|Median: $80.53
1.6× median
96413Top 25%

Chemotherapy administration, IV infusion, up to 1 hour

$1.9M

12K claims · 1.3%

Your Cost: $158.38/claim|Median: $75.28
2.1× median
99282Normal range

Emergency dept visit, low complexity

$1.8M

22K claims · 1.3%

Your Cost: $81.59/claim|Median: $37.72
2.2× median
74177Normal range

CT abdomen and pelvis with contrast

$1.6M

12K claims · 1.1%

Your Cost: $125.70/claim|Median: $65.76
1.9× median
96365Normal range

IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour

$1.5M

17K claims · 1.1%

Your Cost: $87.14/claim|Median: $54.77
1.6× median
99291Top 5%

Critical care, first 30-74 minutes

$1.5M

3K claims · 1.0%

Your Cost: $458.96/claim|Median: $101.24
4.5× median
43239Top 25%

Upper GI endoscopy with biopsy

$1.4M

4K claims · 1.0%

Your Cost: $372.57/claim|Median: $151.68
2.5× median
78815Normal range

PET imaging for limited area

$1.3M

2K claims · 0.9%

Your Cost: $626.99/claim|Median: $325.10
1.9× median
71046Top 10%

Chest X-ray, 2 views

$1.2M

31K claims · 0.8%

Your Cost: $38.76/claim|Median: $8.92
4.3× median
77412Normal range

$1.2M

10K claims · 0.8%

Your Cost: $112.12/claim|Median: $111.69
1.0× median
G0381Normal range

$1.2M

15K claims · 0.8%

Your Cost: $74.56/claim|Median: $59.47
1.3× median
95810Top 25%

Polysomnography, sleep study, 6+ hours

$1.1M

2K claims · 0.8%

Your Cost: $609.10/claim|Median: $233.73
2.6× median
J0585Normal range

Injection, onabotulinumtoxinA, 1 unit

$1.1M

3K claims · 0.8%

Your Cost: $381.68/claim|Median: $470.36
0.8× median
G0330Top 25%

$1.1M

467 claims · 0.8%

Your Cost: $2,299.44/claim|Median: $1,205.70
1.9× median
42820Top 1%

Tonsillectomy and adenoidectomy, under age 12

$1.0M

216 claims · 0.7%

Your Cost: $4,765.48/claim|Median: $331.68
14.4× median
Q9991Normal range

$987K

625 claims · 0.7%

Your Cost: $1,578.98/claim|Median: $1,554.42
1.0× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$981K

34K claims · 0.7%

Your Cost: $28.45/claim|Median: $37.81
0.8× median
93306Top 25%

Echocardiography, transthoracic, complete, with Doppler

$930K

5K claims · 0.7%

Your Cost: $184.80/claim|Median: $54.68
3.4× median
70553Normal range

MRI brain without contrast, then with contrast

$921K

4K claims · 0.6%

Your Cost: $255.31/claim|Median: $133.68
1.9× median
Q5121Normal range

$921K

740 claims · 0.6%

Your Cost: $1,244.17/claim|Median: $1,326.64
0.9× median

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