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.

Apogee Medical Group, Delaware, Inc (NPI 1326485285)

Key Findings

Field	Value
Entity Type	Organization
Organization	Apogee Medical Group, Delaware, Inc
Address	640 S State St
City	Dover
State	DE
ZIP	19901
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 31, 2013

Payer Source	Total Paid
Medicaid	$7.9M
Medicare	$0

APOGEE MEDICAL GROUP, DELAWARE, INC has no Medicare billing on file and reports $7.9M in lifetime Medicaid revenue, making its billed footprint effectively single‑payer Medicaid in the available data. Analysts should treat Medicaid as the dominant and sole reported federal payer for this provider when assessing revenue exposure and contract leverage.

Revenue is highly concentrated in a small set of inpatient E/M codes: the top 3 Medicaid codes (99232, 99233, 99223) account for 68.3% of the provider’s total Medicaid revenue. Those three codes individually generate $2.4M (99232, 29.8%), $1.7M (99233, 20.9%), and $1.4M (99223, 17.6%) of Medicaid revenue, indicating heavy reliance on a narrow code mix.

The code mix—dominated by 99232, 99233, and 99223—signals an operation focused on hospital inpatient and observation care (initial and subsequent inpatient E/M at moderate to high complexity). Supplementary codes such as 99238/99239 for discharge day management and 99291 for critical care further indicate the practice delivers both routine inpatient follow‑up and higher‑acuity services tied to hospital workflows.

APOGEE is a competitive, high‑volume statewide player for multiple inpatient codes: 99232 ranks #2 of 77 providers in the state (99th percentile; extreme outlier), 99233 ranks #2 of 53 (98th percentile; extreme outlier), and 99223 ranks #2 of 60 (98th percentile; extreme outlier). The provider also ranks #1 of 7 for 99220 (100th percentile) and #1 of 3 for 99225 (100th percentile), indicating repeated top positions among in‑state peers for inpatient E/M services.

Scale of activity is substantial on a claims basis: 99232 shows 112.5K claims, 99233 shows 40.3K claims, and 99223 shows 20.2K claims—each representing large volumes that drive the Medicaid revenue profile. High claim counts combined with the large dollar shares underscore that revenue and operational throughput are driven by frequent, routine inpatient encounters.

There is a mixed acuity profile within the inpatient work: the provider bills 99291 (critical care) producing $324.4K but ranks #7 of 24 (74th percentile), described as typical and unremarkable for that code, while discharge and subsequent visit codes such as 99239 ($437.6K; 92th percentile; notably above typical) and 99231 ($224.5K; 98th percentile; extreme outlier) show stronger relative dominance. This suggests the practice’s comparative strength is in repeated inpatient management and discharge workflows rather than in critical care billing.

Operational and contracting implications: because such a large share of Medicaid revenue is tied to inpatient E/M throughput, shifts in hospital admission patterns, observation status policies, or inpatient staffing relationships could materially affect revenue. Payers and provider partners should treat inpatient admission and discharge volumes as the primary drivers of financial performance for this entity.

The NPI was enumerated on 2013-05-31 (~13 years ago), indicating the provider has an established Medicaid billing history over multiple years; that tenure combined with the concentrated, high‑rank inpatient coding pattern points to a mature, hospital‑oriented service line rather than a recently formed outpatient clinic.

Medicaid: Complete Services Breakdown

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	112,520	$20	$2.4M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	40,290	$40	$1.7M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	20,180	$70	$1.4M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	15,630	$30	$437.6K
99220	N/A	6,490	$60	$415.2K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	13,410	$30	$402.4K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	9,260	$40	$352K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	3,820	$90	$324.4K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	20,410	$10	$224.5K
99217	N/A	4,470	$20	$107.2K

Showing 1–10 of 15

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

Apogee Medical Group, Delaware, Inc — 8 of 15 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

15 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	7	20	1,350	$120	$348.4K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2	50	1,030	$60	$292.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	2	80	940	$30	$277.8K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	2	10	900	$50	$192.6K
99220	N/A	1	10	1,070	$70	$150.3K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	2	60	240	$80	$148.4K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	3	30	690	$50	$128.4K
99225	N/A	1	10	5,000	$20	$104.8K
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	3	70	260	$60	$96.7K
99219	N/A	2	10	140	$60	$68.6K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Abbas Omais	MD	Pulmonary Disease Physician	$454.3K	$9K
Angad Singh	PA	Internal Medicine Physician	$416K	$0
Edris Meda	DC	Internal Medicine Physician	$225.8K	$0
Alvaro Toledo Rivera	PA	Internal Medicine Physician	$201.4K	$0
Curtis Smith	DE	Family Medicine Physician	$188K	$0
Sambhab Kumar	DE	Internal Medicine Physician	$170.3K	$830
John Basarich	WI	Family Medicine Physician	$159K	$0
Naveed Hasan	DE	Pulmonary Disease Physician	$153.6K	$0
Navin Victor	NE	Pulmonary Disease Physician	$148.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$79.3M
Bayhealth Emergency Physicians LLC	DE	Emergency Medicine Physician	$0	$16.7M
Ahl And O'connor Orthodontics, LLC	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$12.5M
Bayhealth Medical Center, Inc	DE	Colon & Rectal Surgery Physician	$0	$12.4M
State Of Delaware	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.2M
The Children's Secret Garden	DE	Medically Fragile Infants and Children Day Care	$0	$8.1M
First State Oral And Maxillofacial Surgery Corp	DE	Oral and Maxillofacial Surgery (Dentist)	$0	$5M
Jamie Ahl	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.9M
Kent Diagnostic Radiology Associates PA	DE	Diagnostic Radiology Physician	$0	$4.6M
The Mind And Body Consortium, LLC.	DE	Psychiatry Physician	$0	$3.9M

Apogee Medical Group, Delaware, Inc — Billing Profile & Reimbursement Data

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Apogee Medical Group, Delaware, Inc — 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