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.

Irene Viola (NPI 1386699122)

Field	Value
Entity Type	Individual
Organization	Irene Viola
Address	1606 Savannah Rd
City	Lewes
State	DE
ZIP	19958
Taxonomy	Internal Medicine Physician
NPI Enumerated	May 23, 2006

Payer Source	Total Paid
Medicare	$753K
Medicaid	$0

Key Findings

Medicare revenue is concentrated in a very small number of physician‑administered drug codes: this provider reported $753K in total Medicare revenue and J0717 alone accounts for $395.2K (51.0% of Medicare revenue), while the top three Medicare codes together account for 75.5% of total Medicare revenue. This degree of concentration indicates the practice’s Medicare economics are heavily dependent on a few high‑value injectable therapies rather than a broad mix of office visit income.

The CPT/HCPCS mix points to an internal‑medicine practice that also functions as an office‑based biologics/medication administration site. Large payments for J0717 and J0897 plus billed units of 96401 and 96372 show routine administration of subcutaneous/intramuscular specialty drugs and antineoplastic agents, while 99214 and G0439 activity reflects ongoing outpatient evaluation/management and annual wellness services.

This provider is effectively single‑payer from a claims perspective: Medicare revenue is $753K and there is no Medicaid billing on file. The absence of Medicaid activity indicates payers and network negotiations, patient mix, and revenue exposure are dominated by Medicare reimbursement policy and coding for physician‑administered drugs.

For the top injectable drugs the provider is a modest national participant rather than a dominant player: J0717 ranks #151 of 848 nationally (reported as typical/unremarkable volume) and J0897 ranks #1903 of 10057 (also typical/unremarkable volume). Those rank positions, combined with the 75.5% revenue concentration in the top three codes, suggest the practice captures meaningful but not outsized national share for these specific biologic products.

In contrast, the provider shows above‑typical volume for core outpatient and preventive services: 99214 ranks #25666 of 479517 and is at the 95th percentile (notably above typical national volume), and G0439 ranks #4558 of 105855 at the 96th percentile (notably above typical national volume). These signals point to a stronger-than-average footprint in established patient visits and annual wellness care relative to peers.

Vaccination and preventive care comprise a consistent secondary revenue stream: codes such as 90662 (97th percentile), 90677 (96th percentile), 91320 (84th percentile), and administration codes like G0008 (93th percentile) appear across the top codes list. High percentile placement for multiple vaccine products indicates the practice actively delivers seasonal and COVID‑19/pneumococcal immunizations in addition to specialty drug administration.

There is a notable reporting anomaly on code 91313: the provider has 170 claims for 91313 but reports $0 revenue and a #10 rank of 489 (98th percentile; notably above typical national volume). This pattern—high claim count with $0 paid—warrants operational review (billing classification, pass‑through products, or other reporting nuances) but should be interpreted as a data pattern rather than an assertion about clinical practice.

The provider’s NPI was enumerated on 2006-05-23 (~20 years ago) and the taxonomy is Internal Medicine Physician, indicating an established outpatient practice profile. Combined tenure with the billing mix (specialty injectables plus high E/M and wellness volume) is consistent with a long‑standing internal medicine office that has incorporated physician‑administered biologics and routine preventive services into its service lines.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

24 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	98,800	$1	$395.2K
J0897	Injection, denosumab, 1 mg	6,960	$20	$125.3K
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…	710	$90	$65K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	290	$130	$38.5K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	490	$60	$28K
91320	This code represents a SARS–CoV–2 vaccine product (tris–sucrose formulation) administered by intramuscular injection to reduce the patient’s risk of contracting COVID–19. The dosage is 30 mcg/0.3 mL.	190	$130	$24.1K
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…	350	$60	$21.9K
90677	This code represents a vaccine product administered intramuscularly to protect against pneumococcal disease, a bacterial infection. This is a 20–valent vaccine, protecting against 20 strains of the…	80	$280	$21.4K
90662	This code represents a flu vaccine product that is a split virus type, contains no preservatives, and has enhanced effectiveness due to a higher antigen content. It is administered as an injection…	260	$70	$18.2K
G0008	Administration of influenza virus vaccine	270	$30	$8.3K

Showing 1–10 of 24

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 24 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

Irene Viola — 0 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

24 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	6	10	98,800	$1	$376.8K
J0897	14	60	3,360	$20	$132.9K
99214	207	1,830	150	$80	$25.5K
91320	38	110	120	$130	$20.4K
96401	7	30	110	$60	$18.4K
G0439	64	490	90	$120	$17.2K
99213	337	1,810	120	$60	$13.6K
20610	86	120	60	$50	$12.4K
90677	14	260	30	$280	$9.4K
90480	86	160	200	$40	$8.5K

Showing 1–10 of 24

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lourdes Aponte	DE	Rheumatology Physician	$3.6M	$0
Morgan Popovich	DE	Physician Assistant	$31.6K	$0

Nearby Providers

Other providers in the same ZIP code as Irene Viola, 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
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
Egnm LLC	DE	Ambulatory Surgical Clinic/Center	$2.2M	$13.6K

Irene Viola — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References