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.

Ephphatha Medical Care Services LLC (NPI 1245884048)

Field	Value
Entity Type	Organization
Organization	Ephphatha Medical Care Services LLC
Address	1350 Middleford Rd Ste 501
City	Seaford
State	DE
ZIP	19973
Taxonomy	General Practice Physician
NPI Enumerated	July 30, 2019

Payer Source	Total Paid
Medicaid	$78K
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,120	$30	$71.9K
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…	40	$80	$3.3K
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…	20	$80	$1.7K
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…	50	$20	$810
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	130	$1	$260

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

Ephphatha Medical Care Services LLC — 0 of 5 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

5 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…	462	500	1,130	$50	$235.1K
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…	193	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…	134	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…	138	190	240	$60	$90.8K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	25	40	1,650	$1	$60.7K

Nearby Providers

Other providers in the same ZIP code as Ephphatha Medical Care Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tidalhealth Nanticoke, Inc	DE	General Acute Care Hospital	$0	$19.2M
Dynamic Therapy Services LLC	DE	Physical Therapist	$0	$12.8M
Addiction Medical Facility, LLC	DE	Substance Abuse Rehabilitation Facility	$98.8K	$9M
Tidalhealth Physician Network, Inc.	DE	Family Medicine Physician	$0	$8.7M
Resouces For Human Development, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.4M
Ambient Medical Care, LLC	DE	Urgent Care Clinic/Center	$0	$3.3M
Lynch, Rodriguez And Keller, PA	DE	Dentist	$0	$3.3M
Tidalhealth Physician Network, Inc.	DE	Family Medicine Physician	$0	$2.9M
Ivonne Herrera	DE	Rheumatology Physician	$2.7M	$0
Seaford Internal Medicine LLC	DE	Internal Medicine Physician	$0	$2.7M

Ephphatha Medical Care Services LLC — Billing Profile & Reimbursement Data

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Ephphatha Medical Care Services LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References