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

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

Del Pilar Medical & Urgent Care PC (NPI 1417031907)

Del Pilar Medical & Urgent Care PC is a geriatric medicine (family medicine) physician provider located in Mishawaka, Indiana. This profile covers 0 Medicare and 80 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Del Pilar Medical & Urgent Care PC
Address	270 E Day Rd Ste 280
City	Mishawaka
State	IN
ZIP	46545
Taxonomy	Geriatric Medicine (Family Medicine) Physician
NPI Enumerated	October 24, 2006

Payer Source	Total Paid
Medicaid	$3.6M
Medicare	$0

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

80 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…	20,030	$70	$1.4M
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…	20,010	$50	$1M
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	1,810	$120	$215.5K
98927	The provider performs controlled manual pressure in five to six body regions to treat somatic and nonsomatic disorders.	3,190	$40	$124.3K
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,…	2,440	$40	$87.7K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	840	$90	$73.3K
94060	The spirometry test is performed with a spirometer. The instrument displays a graphical representation, known as a spirogram, of the test results. The basic forced volume vital capacity (FVC) test is…	2,010	$30	$54.4K
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…	620	$90	$53.9K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	1,170	$50	$53.7K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	560	$90	$50.8K

Showing 1–10 of 80

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Indiana providers billing the same CPT/HCPCS codes.

Claims Volume vs. Indiana Distribution

Del Pilar Medical & Urgent Care PC — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

80 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…	140	2,120	870	$60	$450.6K
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…	203	2,380	920	$50	$376.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	285	290	770	$80	$250.8K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	71	270	470	$30	$171.9K
87636	The lab analyst performs the technical steps to detect and differentiate severe acute respiratory syndrome coronavirus 2 (SARS–CoV–2), influenza A, and influenza B using a multiplex amplified nucleic…	14	50	310	$90	$169.3K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	301	320	310	$80	$133.9K
99204	The provider sees a new 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 provider…	648	790	150	$90	$99.4K
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…	141	510	180	$90	$93.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	166	210	5,200	$10	$83.7K
99203	The provider sees a new 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 provider…	649	890	160	$60	$76.8K

Showing 1–10 of 80

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	General Acute Care Hospital	$0	$18.7M
Toxusa Labs LLC	IN	Clinical Medical Laboratory	$1.3M	$9.6M
Pic Indiana PC	IN	Urgent Care Clinic/Center	$0	$10.7M
Radiology, Inc	IN	Diagnostic Radiology Physician	$0	$6.8M
Miracle Lane Family Dentistry P.C.	IN	Dental Clinic/Center	$0	$5.1M
Michiana Eye Center LLC	IN	Ophthalmology Physician	$0	$5M
Saint Joseph Regional Medical Center-south Bend Campus, Inc.	IN	Family Medicine Physician	$0	$4.8M
Northern Indiana Interim Healthcare Company LLC	IN	Home Health Agency	$0	$4.5M
Michiana Hematology-oncology P C	IN	Medical Oncology Physician	$0	$3M
Linda Monroe	IN	Clinical Psychologist	$15.4K	$2.9M

Del Pilar Medical & Urgent Care PC — Billing Profile & Reimbursement Data

Sign up for Del Pilar Medical & Urgent Care PC — Billing Profile & Reimbursement Data policy alerts

Del Pilar Medical & Urgent Care PC — Billing Profile & Reimbursement Data

Sign up for Del Pilar Medical & Urgent Care PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References