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Mainegeneral Medical Center

General Acute Care Hospital·Augusta, ME·NPI: 1669423380Share

Compared to General Acute Care Hospital Peers

Total spending distribution among 156 providers in this specialty

P25MedianP75P90

This provider's total spending of $167.8M is at the 50th percentile among 156 General Acute Care Hospital providers.

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

Total Paid

$167.8M

$167,777,038

Total Claims

4.8M

Beneficiaries

3.9M

1.2 claims/patient

Avg Cost/Claim

$35

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

🔍 Analysis

Provider Overview

Mainegeneral Medical Center is a General Acute Care Hospital provider based in Augusta, ME. From the 2018–2024 period, this provider received $167.8M in Medicaid payments across 4.8M claims.

Why This Matters

This provider received $167.8M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 20,972 Medicaid beneficiaries for a full year at average per-enrollee costs.

↑ 56% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$17.7M
+23%
2019
$21.7M
-12%
2020
$19.1M
+32%
2021
$25.2M
+11%
2022
$28.1M
+1%
2023
$28.4M
-3%
2024
$27.6M

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 28% of total spending.

G0463Top 25%

Hospital outpatient clinic visit

$46.9M

716K claims · 28.0%

Your Cost: $65.52/claim|Median: $26.41
2.5× median
99283Top 25%

Emergency dept visit, moderate complexity

$8.3M

83K claims · 5.0%

Your Cost: $100.29/claim|Median: $42.48
2.4× median
99214Normal range

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

$8.3M

215K claims · 5.0%

Your Cost: $38.78/claim|Median: $53.41
0.7× median
99284Top 25%

Emergency dept visit, high complexity

$7.7M

67K claims · 4.6%

Your Cost: $114.94/claim|Median: $69.51
1.6× median
99213Normal range

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

$6.6M

242K claims · 3.9%

Your Cost: $27.16/claim|Median: $37.81
0.7× median
J9271Normal range

Injection, pembrolizumab, 1 mg

$6.5M

1K claims · 3.9%

Your Cost: $4,324.63/claim|Median: $5,391.55
0.8× median
J3380Normal range

Injection, vedolizumab, one milligram

$4.9M

1K claims · 2.9%

Your Cost: $3,872.45/claim|Median: $4,027.41
1.0× median
99285Top 10%

Emergency dept visit, high/urgent complexity

$4.5M

18K claims · 2.7%

Your Cost: $250.56/claim|Median: $85.65
2.9× median
74177Top 25%

CT abdomen and pelvis with contrast

$2.2M

13K claims · 1.3%

Your Cost: $166.38/claim|Median: $65.76
2.5× median
96374Top 25%

Therapeutic/prophylactic/diagnostic IV push, single substance

$2.0M

20K claims · 1.2%

Your Cost: $99.39/claim|Median: $21.76
4.6× median
96365Normal range

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

$1.8M

20K claims · 1.1%

Your Cost: $90.12/claim|Median: $54.77
1.6× median
96413Normal range

Chemotherapy administration, IV infusion, up to 1 hour

$1.8M

15K claims · 1.1%

Your Cost: $121.45/claim|Median: $75.28
1.6× median
90853Top 25%

Group psychotherapy

$1.8M

38K claims · 1.0%

Your Cost: $45.75/claim|Median: $25.02
1.8× median
78815Normal range

PET imaging for limited area

$1.7M

3K claims · 1.0%

Your Cost: $525.33/claim|Median: $325.10
1.6× median
43239Normal range

Upper GI endoscopy with biopsy

$1.6M

8K claims · 1.0%

Your Cost: $218.26/claim|Median: $151.68
1.4× median
45385Normal range

Colonoscopy with polyp removal, snare technique

$1.6M

4K claims · 0.9%

Your Cost: $365.85/claim|Median: $255.17
1.4× median
99282Normal range

Emergency dept visit, low complexity

$1.5M

25K claims · 0.9%

Your Cost: $62.11/claim|Median: $37.72
1.6× median
99232Normal range

Subsequent hospital care, per day, moderate complexity

$1.3M

48K claims · 0.8%

Your Cost: $27.41/claim|Median: $23.99
1.1× median
J1745Normal range

Injection, infliximab, excludes biosimilar, 10 mg

$1.3M

1K claims · 0.8%

Your Cost: $1,305.32/claim|Median: $1,587.53
0.8× median
92012Top 25%

Ophthalmological exam, intermediate, established patient

$1.3M

24K claims · 0.8%

Your Cost: $54.01/claim|Median: $38.23
1.4× median
G0480Normal range

Drug test, definitive, 1-7 drug classes

$1.2M

63K claims · 0.7%

Your Cost: $19.77/claim|Median: $37.56
0.5× median
97110Normal range

Therapeutic exercises, each 15 min

$1.2M

61K claims · 0.7%

Your Cost: $20.11/claim|Median: $24.49
0.8× median
90837Normal range

Psychotherapy, 60 minutes

$1.1M

16K claims · 0.7%

Your Cost: $68.66/claim|Median: $85.66
0.8× median
77386Normal range

Intensity modulated radiation treatment delivery, complex

$1.1M

4K claims · 0.7%

Your Cost: $267.94/claim|Median: $260.56
1.0× median
90847Normal range

Family psychotherapy with patient, 50 min

$1.1M

12K claims · 0.6%

Your Cost: $93.90/claim|Median: $77.33
1.2× median
71046Top 10%

Chest X-ray, 2 views

$1.1M

30K claims · 0.6%

Your Cost: $35.65/claim|Median: $8.92
4.0× median
80307Normal range

Drug test, presumptive, by chemistry analyzers

$1.1M

83K claims · 0.6%

Your Cost: $13.06/claim|Median: $35.43
0.4× median
90834Normal range

Psychotherapy, 45 minutes

$1.0M

14K claims · 0.6%

Your Cost: $74.14/claim|Median: $63.65
1.2× median
99215Normal range

Office/outpatient visit, high complexity

$1.0M

17K claims · 0.6%

Your Cost: $58.91/claim|Median: $74.09
0.8× median
Q9991Normal range

$973K

602 claims · 0.6%

Your Cost: $1,616.70/claim|Median: $1,554.42
1.0× median

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