Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Delaware for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Delaware only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Delaware (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Bayhealth Medical Center, Inc. (NPI 1023006434)

Field	Value
Entity Type	Organization
Organization	Bayhealth Medical Center, Inc.
Address	100 Wellness Way
City	Milford
State	DE
ZIP	19963
Taxonomy	General Acute Care Hospital
NPI Enumerated	October 10, 2005

Payer Source	Total Paid
Medicaid	$39.5M
Medicare	$0

Key Findings

This provider is effectively single-payer in the available data: there is no Medicare billing on file while Medicaid revenue totals $39.5M, so Medicaid dominates reported reimbursement and operational exposure. Analysts should treat Medicaid as the primary commercial lens for utilization and revenue strategy because Medicare activity is absent from these records.

Revenue is heavily concentrated in emergency department evaluation-and-management codes: the top three Medicaid codes account for 40.4% of the provider's total Medicaid revenue, led by 99283 at $6.1M (19.4%), followed by 99284 at $3.7M (11.8%) and 99282 at $2.9M (9.3%). This concentration indicates that a large share of Medicaid dollars flows through acute ED encounters rather than elective or ambulatory specialty procedures.

The coding mix points to an ED- and acute-care–oriented operation supported by imaging and inpatient observation services. High counts and revenue for ED E/M codes (99283: 34K claims, 99284: 18.7K claims, 99282: 16.4K claims) are complemented by observation billing G0378 (9.9K claims, $1.5M, 4.9%) and advanced imaging such as 74177 (6.2K claims, $2.3M, 7.3%), which together suggest frequent short-stay management and diagnostic-driven workflows.

State-level competitive standing for core ED codes is solid but not dominant: 99283 ranks #8 of 26 in-state (72nd percentile), 99284 ranks #12 of 35 (68th percentile), and 99282 ranks #4 of 16 (80th percentile). These percentiles indicate the provider is a meaningful regional ED player with typically unremarkable volumes for those codes rather than an outlier market leader.

Laboratory and specimen throughput is a notable operational strength. High-volume ancillary codes include 85025 with 60.9K claims generating $852.1K (2.7%) and 36415 with 80.8K claims generating $323K (1.0%); both codes rank #3 in-state and sit at the 94th percentile, described as notably above typical state volume, which implies substantial lab/Phlebotomy throughput supporting ED and inpatient care.

Observation and clinic management capacity is material to the business model: G0378 (hospital observation service) produced $1.5M (4.9%) from 9.9K claims and ranks #2 of 7 in-state (83rd percentile), while G0463 (hospital outpatient clinic visit) produced $1.1M (3.4%) from 14.4K claims and ranks #3 of 7 (67th percentile). Together these codes signal a sustained mix of observation and outpatient-clinic activity beyond one-time ED visits.

The provider maintains a broad imaging and cardiac diagnostic capability at moderate statewide share. Cardiac echo 93306 generated $1.6M (5.1%) from 3.5K claims (rank #11 of 24, 57th percentile) and chest/CT codes such as 70450 and 74177 together account for multiple high-revenue imaging lines, indicating institutional investment in imaging but not a top-tier statewide lead for these services.

This entity has a long operational tenure in registries: NPI was enumerated on 2005-10-10 (~21 years ago), which supports interpreting these utilization patterns as established practice-level behavior rather than transient startup activity. Tenure combined with concentrated ED-driven Medicaid revenue suggests planning and contracting should account for stable acute-care capacity rather than emerging specialty lines.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

284 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	33,960	$180	$6.1M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	18,690	$200	$3.7M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	16,440	$180	$2.9M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6,250	$370	$2.3M
99281	The provider sees a patient for the lowest level emergency department visit.	10,230	$160	$1.6M
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	3,450	$460	$1.6M
G0378	Hospital observation service, per hour	9,850	$160	$1.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	8,720	$140	$1.2M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	14,450	$70	$1.1M
0241U	N/A	3,680	$280	$1M

Showing 1–10 of 284

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.

Claims Volume vs. Delaware Distribution

Bayhealth Medical Center, Inc. — 0 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

284 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	8	30	11,180	$110	$3.4M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	12	40	770	$110	$1.9M
G0378	Hospital observation service, per hour	2	10	6,600	$190	$1.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	14	30	1,350	$110	$1.5M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	4	20	4,570	$120	$1.4M
99281	The provider sees a patient for the lowest level emergency department visit.	3	10	110	$130	$1M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	6	10	4,520	$120	$820.3K
93005	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	4	10	19,210	$30	$794.8K
0241U	N/A	6	10	2,480	$120	$788.1K
U0004	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by…	6	10	3,340	$50	$710.4K

Showing 1–10 of 284

Related Providers

Other providers that share a Tax Identification Number (TIN) with Bayhealth Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$79.3M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Bayhealth Medical Center, Inc	DE	Colon & Rectal Surgery Physician	$0	$12.4M
Bayhealth Medical Center, Inc.	DE	Clinic/Center	$0	$3.7M
Tyler Yerkes	DE	Physician Assistant	$1.1M	$0
Eranga Haththotuwa	DE	Cardiovascular Disease Physician	$694.5K	$0
Sankalp Pathak	NJ	Interventional Cardiology Physician	$639.9K	$0
Pranitha Naini	VA	Medical Oncology Physician	$595.3K	$0
Megdad Zaatreh	NJ	Neurology Physician	$582.2K	$3.8K
Bayhealth Medical Center, Inc	DE	Anatomic Pathology Physician	$0	$502.9K

Nearby Providers

Other providers in the same ZIP code as Bayhealth Medical Center, Inc., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Banyan Delaware LLC	DE	Substance Abuse Rehabilitation Facility	$0	$30.9M
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$28.5M
Epic Health Services (de), LLC	DE	Home Health Agency	$0	$19.3M
Delaware Pediatric Dentistry	DE	Pediatric Dentistry	$0	$18.1M
Kent-sussex Industries	DE	Developmentally Disabled Services Day Training Agency	$0	$11.7M
Nurses 'n Kids Of Milford, Inc.	DE	Medically Fragile Infants and Children Day Care	$0	$9.5M
Prn Staffers Inc	DE	Home Health Agency	$0	$7.6M
People's Place Ii, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.9M
La Red Health Center, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$2.7M
Lab At Seascape	DE	Clinical Medical Laboratory	$1M	$471.9K

Bayhealth Medical Center, Inc. — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References