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.

Medexpress, Inc - Delaware (NPI 1255692182)

Key Findings

Field	Value
Entity Type	Organization
Organization	Medexpress, Inc - Delaware
Address	2722 Concord Pike
City	Wilmington
State	DE
ZIP	19803
Taxonomy	Family Medicine Physician
NPI Enumerated	June 7, 2012

Payer Source	Total Paid
Medicaid	$7.9M
Medicare	$0

This provider has no Medicare billing on file and reported $7.9M in lifetime Medicaid revenue, making it effectively a Medicaid-focused operation rather than a mixed Medicare/Medicaid practice. Analysts should treat payer exposure and competitive comparisons primarily through the lens of Delaware Medicaid activity.

Revenue is highly concentrated: the top three Medicaid codes account for 77.6% of total Medicaid revenue. Those three are S9083 ($3.1M, 39.2%), 99214 ($1.7M, 22.1%), and 99213 ($1.3M, 16.4%), indicating that a small set of service lines drives the bulk of receipts.

The procedure mix points to an urgent care–oriented, high-volume ambulatory model: S9083 (Global fee urgent care centers) is the single largest revenue source and is paired with very large volumes of office E/M codes 99214 and 99213. High counts of 99203 (21.5K claims, $947K revenue, 12.0%) further show substantial new‑patient throughput, consistent with a walk‑in or urgent‑care practice that also manages established patients.

Competitive standing in-state is strong for the provider’s top lines. S9083 ranks #1 of 24 providers in-state (100th percentile, notably above typical state volume), 99214 ranks #8 of 504 providers (99th percentile; labeled an extreme outlier), and 99203 ranks #2 of 187 providers (99th percentile; extreme outlier), collectively indicating dominance on urgent‑care and high‑acuity E/M volume in Delaware.

The provider also reports outsized diagnostic/testing throughput that supports visit volume: 87426 (SARS–CoV–2 immunoassay) shows 10.3K claims and $360.1K revenue and ranks #1 of 24 providers in-state (100th percentile; extreme outlier), while rapid influenza (87804) and rapid strep (87880) testing each show very high claim counts and top percentile rankings. This pattern suggests on‑site point‑of‑care testing is an important ancillary service linked to visits.

Average paid per claim on the top revenue codes is relatively low compared with their claim volumes (S9083 $77 avg paid/claim, 99214 $44 avg paid/claim, 99213 $61 avg paid/claim), which is consistent with a high‑throughput, lower‑unit‑reimbursement business model. Financial performance therefore appears driven more by visit and test volume than by high unit prices.

Concentration of revenue into a few codes creates operational sensitivity: because S9083, 99214, and 99213 together drive 77.6% of Medicaid revenue, changes in coverage, reimbursement policy, or utilization patterns for urgent‑care/global urgent‑care fees and core E/M visits would materially affect this provider’s Medicaid revenue. Payers and contracting teams should note this leverage when modeling downside scenarios.

This NPI was enumerated on 2012-06-07 (approximately 14 years ago), indicating a relatively long-established billing presence in the market; combined with the provider’s high percentile ranks on multiple high-volume codes, the data support a view of an established, high-volume ambulatory/urgent‑care operator rather than a recent entrant.

Medicaid: Complete Services Breakdown

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S9083	Global fee urgent care centers	39,980	$80	$3.1M
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…	39,430	$40	$1.7M
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…	21,120	$60	$1.3M
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…	21,520	$40	$947K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	10,290	$40	$360.1K
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…	2,830	$90	$262.8K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	1,450	$60	$81.2K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	14,850	$1	$29.7K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	350	$60	$20.8K
87811	The lab analyst performs the technical lab test to analyze for the presence of severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2) (Coronavirus disease [COVID–19]) in a specimen by…	1,790	$10	$16.1K

Showing 1–10 of 46

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

Medexpress, Inc - Delaware — 7 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

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S9083	Global fee urgent care centers	1	20	1,320	$80	$576.2K
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…	8	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…	23	540	1,100	$40	$185.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	41	50	800	$70	$170.9K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	29	50	470	$80	$126.7K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	133	150	230	$90	$110.4K
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…	17	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…	2	190	240	$60	$90.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	14	30	770	$10	$70.6K
94640	The provider administers oxygen under pressure or not under pressure to open obstructed air passages. He uses any of the listed devices to treat a patient with an acute obstruction of the airway that…	8	20	390	$40	$69.1K

Showing 1–10 of 46

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Nemours Foundation	DE	Multi-Specialty Clinic/Center	$0	$172M
The Nemours Foundation	DE	Children's Hospital	$0	$104M
Jevs Human Services	DE	Adult Development & Aging Psychologist	$0	$84.4M
Christiana Care Home Health And Community Services, Inc.	DE	Home Health Agency	$0	$44.1M
Children's Dental Health Of Delaware - Wilmington, PA	DE	Pediatric Dentistry	$0	$8M
Radnon Home Care LLC	DE	In Home Supportive Care Agency	$0	$6.5M
Delaware Cardiovascular Associates, P.A.	DE	Cardiovascular Disease Physician	$0	$5.4M
Concord Dental, LLC	DE	Dental Clinic/Center	$0	$4.2M
Christiana Care Health Services Inc	DE	Student Health Clinic/Center	$0	$3.9M
Dental Management Strategies LLC	DE	Dentist	$0	$2.9M

Medexpress, Inc - Delaware — Billing Profile & Reimbursement Data

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Medexpress, Inc - Delaware — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Imelyn Lahey	DE	Family Medicine Physician	$212.5K	$0
Preet Joshi	DE	Family Medicine Physician	$29.8K	$0
Nicole Dirienzo	DE	Medical Physician Assistant	$22.1K	$0