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 Washington for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Washington 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. Washington (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.

Philip Delich (NPI 1407858889)

Field	Value
Entity Type	Individual
Organization	Philip Delich
Address	105 W 8th Ave
City	Spokane
State	WA
ZIP	99204
Taxonomy	Gastroenterology Physician
NPI Enumerated	August 15, 2005

Payer Source	Total Paid
Medicare	$24.6K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 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…	90	$90	$7.3K
43244	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and treats enlarged blood vessels in the esophagus or stomach with band ligation, i.e.,…	30	$180	$5.6K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	60	$80	$4.3K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	10	$200	$2.2K
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.	30	$70	$2.1K
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…	30	$60	$2K
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…	10	$80	$920

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Washington Distribution

Philip Delich — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Washington

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
45385	368	380	70	$290	$31K
99214	5,788	10,860	100	$80	$13.6K
43239	292	370	60	$120	$9.3K
99232	2,265	3,100	70	$60	$7.5K
43244	2	10	30	$170	$5.4K
99222	1,595	1,690	20	$100	$3K
43235	9	180	20	$120	$2.9K

Philip Delich — Billing Profile & Reimbursement Data

Sign up for Philip Delich — Billing Profile & Reimbursement Data policy alerts

Philip Delich — Billing Profile & Reimbursement Data

Sign up for Philip Delich — Billing Profile & Reimbursement Data policy alerts

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References