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.

Lewes Surgical & Medical Associates, P.A. (NPI 1265461263)

Lewes Surgical & Medical Associates, P.A. is a internal medicine physician provider located in Millsboro, Delaware. This profile covers 0 Medicare and 45 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Lewes Surgical & Medical Associates, P.A.
Address	Cedar Tree Medical Center
City	Millsboro
State	DE
ZIP	19966
Taxonomy	Internal Medicine Physician
NPI Enumerated	July 2, 2006

Payer Source	Total Paid
Medicaid	$99.9K
Medicare	$0

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	1,220	$20	$25.7K
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…	1,490	$20	$23.8K
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…	5,350	$1	$21.4K
88342	The lab analyst applies an initial single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist,…	590	$30	$15.2K
88341	The lab analyst applies an additional single antibody stain on a slide or slides prepared from the same patient specimen as the initial antibody stain, such as tumor tissue. Then a qualified…	60	$100	$5.9K
88313	The lab analyst performs the technical lab steps to stain a specimen for Group II identification, for example an iron stain or trichrome stain. A qualified provider, typically a pathologist,…	160	$20	$3.7K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	30	$100	$3K
88304	The physician, typically a pathologist, performs a level III examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	30	$10	$300
88312	The lab analyst performs the technical lab steps to stain a specimen with a special stain. This code applies to Group I for microorganisms. A qualified provider, typically a pathologist, interprets…	130	$1	$270
17000	The provider destroys a premalignant lesion using techniques such as chemosurgery, cryosurgery, electrosurgery, or others. This code reports the destruction of the first or only lesion.	50	$10	$230

Showing 1–10 of 45

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

Lewes Surgical & Medical Associates, P.A. — 0 of 14 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

45 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	12	10	19,870	$20	$426.3K
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.	22	20	3,450	$30	$287.8K
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…	232	500	1,130	$50	$235.1K
80048	The lab analyst performs a basic metabolic pane (BMP) test in which he measures the blood level of eight chemicals including total calcium, sodium, potassium, chloride, carbon dioxide, glucose, blood…	12	10	7,360	$10	$214.1K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	8	10	3,230	$50	$210.3K
88305	The physician, typically a pathologist, performs a level IV examination of a surgical pathology specimen. The examination includes accessioning the specimen into the lab, which involves formally…	17	30	1,880	$60	$191.1K
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…	113	540	1,100	$40	$185.3K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	27	30	960	$10	$178.7K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	32	30	490	$180	$168.8K
80354	The lab analyst measures the amount of or detects the presence of fentanyl in the patient specimen.	2	10	14,710	$10	$117K

Showing 1–10 of 45

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ctm Medical Associates LLC	DE	Surgery Physician	$0	$1.9M
Fady Gerges	DE	Anatomic Pathology Physician	$906.3K	$0
Mohamed Ahmed	MD	Pain Medicine (Anesthesiology) Physician	$367.4K	$0
Semaan Abboud	DE	Internal Medicine Physician	$202.9K	$0
Fabricio Alarcon	DE	Internal Medicine Physician	$157K	$0
Cheryl Zdana	DE	Pain Management Registered Nurse	$136K	$0
Allison Hager	DE	Dermatology Physician	$132.5K	$0
Cts Surgical Associates LLC	DE	Ambulatory Surgical Clinic/Center	$105.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
National Mentor Healthcare, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$108.7M
Coras Wellness And Behavioral Health, LLC	DE	Substance Use Disorder Rehabilitation Clinic/Center	$703K	$18.2M
Peninsula Dental, LLC	DE	General Practice Dentistry	$0	$12.3M
Sleepy Tooth Orthodontics LLC	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$8.3M
Green Valley Terrace Snf LLC	DE	Skilled Nursing Facility	$0	$822K
Georges Dahr	DE	Cardiovascular Disease Physician	$763.7K	$0
Millsboro Fire Company Inc.	DE	Land Ambulance	$517.4K	$165.3K
Mid Sussex Rescue Squad Inc.	DE	Ambulance	$497.1K	$178K
William Singleton	DE	Addiction (Substance Use Disorder) Counselor	$0	$636.8K
Beebe Medical Center, Inc.	DE	Home Health Agency	$0	$559.9K

Lewes Surgical & Medical Associates, P.A. — Billing Profile & Reimbursement Data

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Lewes Surgical & Medical Associates, P.A. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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