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 North Carolina for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Daniel Delo (NPI 1114128618)

Field	Value
Entity Type	Individual
Organization	Daniel Delo
Address	1710 S 17th St
City	Wilmington
State	NC
ZIP	28401
Taxonomy	Rheumatology Physician
NPI Enumerated	May 30, 2007

Payer Source	Total Paid
Medicare	$2.8M
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the dominant payer relationship: total Medicare revenue is $2.8M while Medicaid is listed as none (no Medicaid billing on file), so the practice is effectively single-payer (Medicare) in scope and financially exposed to Medicare policy and reimbursement changes. The NPI was enumerated 2007-05-30 (~19 years ago), indicating a long-tenured provider who has had time to build clinical and billing workflows around Medicare populations.

Revenue is highly concentrated in a small set of biologic infusion codes: the precomputed top 3 Medicare codes account for 69.4% of total Medicare revenue, driven by J0129 ($1.2M, 40.6%), J1602 ($424.9K, 14.9%), and J3262 ($395.2K, 13.9%). This concentration indicates the practice’s financial performance depends principally on in-office administration of high-cost biologic products.

The code mix and top revenue items indicate an infusion-centric rheumatology practice: dominant J-codes include J0129 (abatacept), J1602 (golimumab IV), J3262 (tocilizumab), J1745 (infliximab, $149.8K) and Q5104 (infliximab biosimilar, $85K), which together reflect routine in-office IV/subcutaneous biologic therapy and biosimilar usage rather than primarily clinic-only management. The presence of add-on infusion/chemotherapy administration codes such as 96413 ($92.4K, 3.2%) and 96415 ($3K) further supports a service line that performs longer infusions and post-initiation monitoring.

Competitive standing is mixed by code: for abatacept administration (J0129) the provider ranks #32 of 1221 providers nationally (97th percentile; notably above typical national volume for this code), identifying them as a major national-volume supplier for that drug. For golimumab (J1602) and tocilizumab (J3262) the provider ranks in high but more typical percentiles (#93 of 1041, 91st percentile; #98 of 618, 84th percentile respectively), indicating solid but not dominant national positions for those agents.

Several codes are statistical outliers versus national peers: 99214 shows 1.2K claims and $105.3K revenue (3.7% of Medicare revenue) and ranks #7643 of 479517 providers nationally (98th percentile; extreme outlier, far above typical national volume for this code), and 96413 shows 943 claims and $92.4K revenue (3.2% of Medicare revenue) and ranks #100 of 7514 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). These outlier E/M and chemotherapy/infusion-administration volumes imply unusually high office visit intensity and infusion throughput relative to peers.

The practice also performs routine rheumatology monitoring and ambulatory testing: lab and imaging codes such as 80076 ($8.5K, 95th percentile), 86140 ($5.5K, 95th percentile), 82565 ($5.4K, 97th percentile), 85025 ($8.9K) and 77080 ($3.6K) appear in the top codes, consistent with ongoing laboratory monitoring, bone density assessment, and inflammation testing that support biologic therapy management. These ancillary services contribute modest revenue but show high relative utilization compared with national peers, reflecting an integrated infusion-and-monitoring workflow.

Operational and financial implications flow from the provider’s spending profile: heavy reliance on in-office administration of specific biologics (J0129, J1602, J3262) means revenue is tied to drug selection, payer reimbursement for infused drugs, and the practice’s ability to maintain infusion capacity. Given top-3 codes represent 69.4% of Medicare revenue, changes in utilization patterns, drug mix (including biosimilars like Q5104), or payer coverage for these agents would disproportionately affect practice revenue.

The combination of long tenure (~19 years), high-percentile biologic administration for J0129, and extreme outlier volumes in 99214 and 96413 suggests an established rheumatology infusion program with significant patient throughput for both evaluation-and-management and infusion services. For analysts, this profile indicates a provider that competes regionally/nationally on biologic infusion volume and maintains a supporting lab/imaging stack to manage chronic rheumatologic therapy.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	34,000	$30	$1.2M
J1602	Injection, golimumab, 1 mg, for intravenous use	38,620	$10	$424.9K
J3262	Injection, tocilizumab, 1 mg	79,040	$10	$395.2K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	5,760	$30	$149.8K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	34,800	$1	$139.2K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	1,170	$90	$105.3K
J3111	Injection, romosozumab-aqqg, 1 mg	13,020	$10	$104.2K
J0897	Injection, denosumab, 1 mg	5,160	$20	$92.9K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	940	$100	$92.4K
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	2,930	$30	$85K

Showing 1–10 of 51

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 51 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. North Carolina Distribution

Daniel Delo — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. state median

51 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0129	2	70	9,530	$30	$393.2K
J3262	9	40	37,160	$1	$224.8K
J0717	21	40	37,400	$1	$178.8K
J1602	5	70	11,900	$10	$175.9K
J3111	20	30	13,970	$10	$135.8K
J1745	22	80	4,110	$30	$117.3K
Q5104	4	10	2,860	$30	$101.3K
86235	9	40	160	$20	$70.1K
J0897	82	430	2,100	$20	$63.9K
86038	28	30	30	$10	$23K

Showing 1–10 of 51

Related Providers

Other providers that share a Tax Identification Number (TIN) with Daniel Delo, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Louisiana State University School Of Med In New Orleans Faculty Grou	LA	Pediatrics Physician	$0	$43M
University Of Pittsburgh Physicians	PA	Psychiatry Physician	$0	$26.4M
University Of Pittsburgh Physicians	PA	Specialist	$0	$23.6M
Ashok Muthukrishnan	FL	Nuclear Radiology Physician	$3.9M	$129.2K
Mark Harris	NC	Rheumatology Physician	$3M	$0
Vimala Ramesh	PA	Anesthesiology Physician	$57.8K	$2.2M
Joseph Shanahan	NC	Rheumatology Physician	$1.9M	$0
Medical Foundation, Inc.	MS	Geriatric Medicine (Family Medicine) Physician	$0	$1.8M
Pamela Rath	PA	Ophthalmology Physician	$1.7M	$17.7K
Christopher Hodge	MA	Anesthesiology Physician	$109.9K	$1.6M

Nearby Providers

Other providers in the same ZIP code as Daniel Delo, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Novant Health New Hanover Regional Medical Center LLC	NC	General Acute Care Hospital	$0	$57.5M
New Hanover Regional Medical Center	NC	General Acute Care Hospital	$0	$23.7M
Access Family Services	NC	Community/Behavioral Health Agency	$0	$15.3M
Care Providers Of Wilmington	NC	Home Health Agency	$0	$10M
Wilmington Health PLLC	NC	Pediatrics Physician	$0	$10M
Ecep Ii PA	NC	Emergency Medicine Physician	$0	$9.7M
Novant Health New Hanover Regional Medical Center LLC	NC	Ambulance	$6.1M	$2.7M
Coastal Horizons Center Inc.	NC	Community/Behavioral Health Agency	$0	$8.7M
New Hanover Community Health Center Incorporated	NC	Federally Qualified Health Center (FQHC)	$0	$8.5M
Kidzcare Pediatrics, PC	NC	Pediatrics Physician	$0	$8.2M

Daniel Delo — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References