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.

Family Medicine Of Middletown, PA. (NPI 1285826131)

Field	Value
Entity Type	Organization
Organization	Family Medicine Of Middletown, PA.
Address	209 E Main St Ste 6
City	Middletown
State	DE
ZIP	19709
Taxonomy	Family Medicine Physician
NPI Enumerated	August 15, 2007

Payer Source	Total Paid
Medicaid	$207.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

2 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…	2,530	$50	$121.5K
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…	1,540	$60	$86K

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

Family Medicine Of Middletown, PA. — 0 of 2 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

2 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…	181	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…	232	540	1,100	$40	$185.3K

Nearby Providers

Other providers in the same ZIP code as Family Medicine Of Middletown, PA., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Center For Interventional Pain Spine LLC	DE	Interventional Pain Medicine Physician	$0	$17.6M
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

Family Medicine Of Middletown, PA. — Billing Profile & Reimbursement Data

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Family Medicine Of Middletown, 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

Nearby Providers

Frequently Asked Questions

References