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.

Milton Enterprises, Inc (NPI 1326128786)

Field	Value
Entity Type	Organization
Organization	Milton Enterprises, Inc
Address	17015 Old Orchard Rd Unit 2
City	Lewes
State	DE
ZIP	19958
Taxonomy	Family Medicine Physician
NPI Enumerated	October 17, 2006

Payer Source	Total Paid
Medicaid	$248.2K
Medicare	$0

Medicaid: Complete Services Breakdown

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

14 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…	4,190	$40	$159.1K
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…	2,650	$30	$84.8K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	90	$40	$3.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	10	$40	$520
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	50	$10	$330
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	20	$10	$140
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…	10	$1	$60
3008F	No Summary found for this code	810	$0	$0
3074F	No Summary found for this code	570	$0	$0
3075F	No Summary found for this code	30	$0	$0

Showing 1–10 of 14

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

Milton Enterprises, Inc — 0 of 7 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

14 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…	135	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…	170	540	1,100	$40	$185.3K
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…	142	150	230	$90	$110.4K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	34	50	170	$70	$41.4K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	164	180	180	$20	$24.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	93	100	230	$1	$6.7K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	24	50	40	$1	$560
3074F	No Summary found for this code	47	90	690	$1	$100
3079F	No Summary found for this code	46	70	340	$1	$40
3078F	No Summary found for this code	46	80	620	$1	$40

Showing 1–10 of 14

Related Providers

Other providers that share a Tax Identification Number (TIN) with Milton Enterprises, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jennifer Hurd	DE	Internal Medicine Physician	$659.8K	$0
Catherine Deluca	DE	Family Medicine Physician	$214.4K	$0

Nearby Providers

Other providers in the same ZIP code as Milton Enterprises, Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beebe Medical Center, Inc.	DE	General Acute Care Hospital	$0	$29.2M
Beebe Physician Network Inc.	DE	Internal Medicine Physician	$0	$19.7M
Juliano Senior Care, Inc.	DE	In Home Supportive Care Agency	$0	$5.9M
Sussex Emergency Associates LLC	DE	Emergency Medicine Physician	$0	$4.3M
Lourdes Aponte	DE	Rheumatology Physician	$3.6M	$0
Jose Pando	DE	Rheumatology Physician	$3.2M	$0
Delaware Psychological Services LLC	DE	Mental Health Counselor	$0	$3M
The Pediatric & Adolescent Center	DE	Specialist	$0	$2.9M
Sea Haven Home Care, LLC	DE	In Home Supportive Care Agency	$0	$2.3M
Southern Delaware Imaging Assoc	DE	Diagnostic Radiology Physician	$0	$2.3M

Milton Enterprises, Inc — Billing Profile & Reimbursement Data

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Milton Enterprises, Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References