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.

Rheumatology Consultants Of De PA (NPI 1124011309)

Field	Value
Entity Type	Organization
Organization	Rheumatology Consultants Of De PA
Address	20268 Plantations Rd
City	Lewes
State	DE
ZIP	19958
Taxonomy	Rheumatology Physician
NPI Enumerated	August 24, 2005

Payer Source	Total Paid
Medicaid	$225.4K
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	3,920	$40	$160.7K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	2,130	$20	$49.1K
99204	The provider sees a new 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 provider…	150	$70	$10.7K
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…	290	$10	$3.8K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	20	$40	$630
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	110	$1	$320
J1030	Injection, methylprednisolone acetate, 40 mg	90	$1	$170
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	20	$1	$30

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

Rheumatology Consultants Of De PA — 0 of 8 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

8 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	140	500	1,130	$50	$235.1K
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…	10	10	2,240	$70	$186.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	192	540	1,100	$40	$185.3K
99204	The provider sees a new 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 provider…	101	180	220	$90	$101.5K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	171	190	240	$60	$90.8K
J3301	Injection, triamcinolone acetonide, not otherwise specified, 10 mg	19	20	260	$1	$2.2K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	36	50	200	$10	$2.2K
J1030	Injection, methylprednisolone acetate, 40 mg	8	10	210	$1	$2K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rheumatology Consultants Of De PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jose Pando	DE	Rheumatology Physician	$3.2M	$0
Anusha Vuppala	CA	Rheumatology Physician	$170.7K	$0
Jennifer Rahn	DE	Physician Assistant	$122.7K	$0
Gregory Sender	DE	Physician Assistant	$81.6K	$0

Nearby Providers

Other providers in the same ZIP code as Rheumatology Consultants Of De PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beebe Medical Center, Inc.	DE	General Acute Care Hospital	$0	$29.2M
Beebe Physician Network Inc.	DE	Internal Medicine Physician	$0	$19.7M
Juliano Senior Care, Inc.	DE	In Home Supportive Care Agency	$0	$5.9M
Sussex Emergency Associates LLC	DE	Emergency Medicine Physician	$0	$4.3M
Lourdes Aponte	DE	Rheumatology Physician	$3.6M	$0
Delaware Psychological Services LLC	DE	Mental Health Counselor	$0	$3M
The Pediatric & Adolescent Center	DE	Specialist	$0	$2.9M
Sea Haven Home Care, LLC	DE	In Home Supportive Care Agency	$0	$2.3M
Southern Delaware Imaging Assoc	DE	Diagnostic Radiology Physician	$0	$2.3M
Egnm LLC	DE	Ambulatory Surgical Clinic/Center	$2.2M	$13.6K

Rheumatology Consultants Of De PA — Billing Profile & Reimbursement Data

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Rheumatology Consultants Of De PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References