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.

Center For Interventional Pain Spine LLC (NPI 1144527003)

Key Findings

Field	Value
Entity Type	Organization
Organization	Center For Interventional Pain Spine LLC
Address	291 Carter Dr Ste A
City	Middletown
State	DE
ZIP	19709
Taxonomy	Interventional Pain Medicine Physician
NPI Enumerated	February 11, 2011

Payer Source	Total Paid
Medicaid	$17.6M
Medicare	$0

This provider bills exclusively to Medicaid on file: Total Medicaid revenue is $17.6M and there is no Medicare revenue reported, so the practice is effectively single-payer (Medicaid)-focused in the available data. Analysts should treat Medicaid as the dominant commercial channel for evaluating scale and utilization patterns.

Revenue is highly concentrated: the precomputed top three Medicaid codes account for 58.6% of the provider's Medicaid revenue, led by 99214 ($4.4M, 30.6%), 99213 ($2.8M, 19.0%), and 96138 ($1.3M, 8.9%). This concentration indicates that a relatively small set of E/M and testing services drive the majority of payments.

The code mix indicates an interventional pain and spine outpatient clinic that combines high-volume office visits with procedural spine care, functional testing, and behavioral/psychological services. High-revenue procedural and diagnostic codes such as 62323 (lumbar/sacral epidural injections), 64635 (lumbar neurolytic procedures), and 62321 (cervical/thoracic injections), together with rehab codes (97110) and orthotic L0648, suggest an integrated pain-management service line offering injections, physical therapy, orthoses, and diagnostic testing.

Competitive standing within the state is dominant for core visit codes: 99214 and 99213 both rank #2 statewide (100th percentile) and are described as "extreme outlier, far above typical state volume for this code," identifying the provider as one of the largest in-state billers for established outpatient visits. Similarly, 96138 ranks #1 of 7 providers (100th percentile) and is labeled "notably above typical state volume," signaling leadership in neuropsychological test administration in the state.

The practice runs a very large drug-testing and medication-monitoring operation alongside clinical care: multiple urine/definitive drug test codes appear with high claim counts and state-leading ranks, including 80348 ($294.1K, 29.4K claims, rank #1 of 4, 100th percentile) and 80307 ($479.8K, 34.3K claims, rank #3 of 23, 91th percentile). These lab and monitoring services (80354, 80361, 80362, 80365, 80369, 80346, 80375) together represent a meaningful ancillary revenue stream and support a management model focused on controlled-substance monitoring and compliance.

The provider also relies on extremely high-claim, low-paid behavioral screening and brief testing volumes: 96127 shows 156.3K claims for $469K (3.2% of Medicaid revenue) and is labeled an "extreme outlier, far above typical state volume for this code." This pattern — large claim counts at low unit payment — suggests operational throughput optimized for frequent brief assessments and standardized screening in addition to longer E/M encounters.

Procedural injection volumes are material and state-leading on several codes: 62323 has 4.3K claims totaling $404.4K (2.8% of Medicaid revenue) and ranks #1 of 9 providers (100th percentile, notably above typical state volume), while 64493 and 64635 also rank #1 in the state for their respective code families. These placements indicate a sustained, procedure-oriented component to revenue that complements the high-volume office visit business.

The provider has established tenure: NPI enumerated on 2011-02-11 (~15 years ago), which combined with persistent high-volume rankings across many codes suggests a long-standing Medicaid-focused operation that has scaled both clinical visits and ancillary testing/procedural services over time. Analysts should view reported patterns as entrenched utilization behavior rather than transient spikes.

Medicaid: Complete Services Breakdown

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

112 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…	103,200	$40	$4.4M
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…	110,330	$30	$2.8M
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	71,780	$20	$1.3M
L0648	Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on…	2,490	$230	$574K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	34,270	$10	$479.8K
92548	The provider performs computerized dynamic posturography sensory organization testing to evaluate the patient's motor, sensory, and integrative processes used to maintain balance and stability. The…	8,420	$60	$471.7K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	156,330	$1	$469K
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…	6,600	$60	$422.3K
62323	The provider injects a diagnostic or a therapeutic substance, such as pain medication or a steroid, into the space around the spinal nerves of the lumbar (lower back) or sacral (caudal, or tailbone)…	4,350	$90	$404.4K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	12,770	$20	$306.6K

Showing 1–10 of 112

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

Center For Interventional Pain Spine LLC — 21 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

112 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
L0648	Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on…	1	10	2,490	$230	$573.8K
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	8	10	1,330	$70	$462.8K
G0482	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	5	10	1,960	$30	$294.9K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	3	20	3,450	$30	$287.8K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	7	10	2,060	$60	$286.8K
92548	The provider performs computerized dynamic posturography sensory organization testing to evaluate the patient's motor, sensory, and integrative processes used to maintain balance and stability. The…	1	10	4,430	$60	$249.1K
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…	2	500	1,130	$50	$235.1K
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	1	10	230	$20	$194.4K
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	540	1,100	$40	$185.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	12	90	2,360	$20	$181.1K

Showing 1–10 of 112

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chee Woo	DE	Pain Medicine Physician	$913.5K	$140
Venkatesh Sundararajan	PA	Pain Medicine Physician	$498.5K	$0
Terence Duffy	DE	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$477K	$0
Maryum Rafique	DE	Physical Medicine & Rehabilitation Physician	$437.2K	$0
Philip Kim	PA	Pain Medicine Physician	$385.9K	$300
Justin Winas	PA	Pain Medicine Physician	$325.9K	$8.6K
Manny Lai	DE	Pain Medicine Physician	$288.6K	$0
Alexander Matz	DE	Pain Medicine Physician	$282.5K	$2.2K
Jason Roth	NJ	Pain Medicine (Physical Medicine & Rehabilitation) Physician	$259.9K	$0
Daniel Nasr	DE	Pain Medicine Physician	$236.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lieske E2e Home Health Care Inc	DE	Home Health Agency	$0	$9.2M
Tobola Health Care Services Inc.	DE	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$4.3M
Delaware Smile Center	DE	General Practice Dentistry	$0	$3.1M
Premier Physical Therapy And Sports Performance Limited Partnership	DE	Physical Therapist	$0	$2.3M
Thrive Real Life Independence, LLC	DE	Developmentally Disabled Services Day Training Agency	$0	$1.2M
Myeyedr Optometry Of Delaware PA	DE	Optometrist	$0	$961.5K
Scy Dental	DE	Dental Clinic/Center	$0	$776.9K
Middletown Familycare Associates LLC	DE	Family Medicine Physician	$0	$719K
Mccormick & Associates Of Middletown, LLC	DE	Psychiatric/Mental Health Clinical Nurse Specialist	$0	$590.7K
Sunwise Dermatology & Surgery LLC	DE	MOHS-Micrographic Surgery Physician	$0	$558.8K

Center For Interventional Pain Spine LLC — 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