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.

Alpha Care Medical, LLC (NPI 1417409905)

Alpha Care Medical, LLC is a family medicine physician provider located in Seaford, Delaware. This profile covers 0 Medicare and 37 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	Alpha Care Medical, LLC
Address	1340 Middleford Rd Ste 401
City	Seaford
State	DE
ZIP	19973
Taxonomy	Family Medicine Physician
NPI Enumerated	October 31, 2016

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

37 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…	26,310	$40	$1.1M
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	4,290	$50	$210.2K
99493	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation in collaboration and in…	2,580	$70	$178.3K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	3,370	$50	$165.2K
G0397	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes	8,980	$20	$161.6K
G0396	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and brief intervention 15 to 30 minutes	5,790	$20	$104.1K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,830	$60	$104K
99484	Clinical staff members spend at least 20 minutes each month coordinating and managing a patient’s behavioral health services under the direction of a physician or other qualified health care…	5,430	$10	$59.7K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	1,750	$30	$56K
99494	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation whose conditions are not…	2,000	$30	$52K

Showing 1–10 of 37

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

Alpha Care Medical, LLC — 5 of 25 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

37 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	8	20	3,450	$30	$287.8K
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…	11	500	1,130	$50	$235.1K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	52	240	700	$60	$205.6K
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	2	10	230	$20	$194.4K
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…	286	540	1,100	$40	$185.3K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	27	80	790	$40	$180.4K
99493	A provider performs psychiatric collaborative care management (CoCM) for a patient receiving behavioral health treatment and regular psychiatric interspecialty consultation in collaboration and in…	1	10	2,580	$70	$177.9K
G0397	Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes	1	10	8,980	$20	$162.2K
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…	42	150	230	$90	$110.4K
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…	81	180	220	$90	$101.5K

Showing 1–10 of 37

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Eunice Boyd-gant	DE	Family Nurse Practitioner	$236.6K	$0
Edward Hendricks	DE	Family Nurse Practitioner	$188.6K	$0
David Gaines	DE	Nurse Practitioner	$0	$69.5K
Anita Tyndall	DE	Family Nurse Practitioner	$58.5K	$0
Sarah Kamara	DE	Family Nurse Practitioner	$29.1K	$0
Michael Balliro	DE	Clinical Social Worker	$15.1K	$0
Tanisha Crockett	DE	Family Nurse Practitioner	$12.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tidalhealth Nanticoke, Inc	DE	General Acute Care Hospital	$0	$19.2M
Dynamic Therapy Services LLC	DE	Physical Therapist	$0	$12.8M
Addiction Medical Facility, LLC	DE	Substance Abuse Rehabilitation Facility	$98.8K	$9M
Tidalhealth Physician Network, Inc.	DE	Family Medicine Physician	$0	$8.7M
Resouces For Human Development, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.4M
Ambient Medical Care, LLC	DE	Urgent Care Clinic/Center	$0	$3.3M
Lynch, Rodriguez And Keller, PA	DE	Dentist	$0	$3.3M
Tidalhealth Physician Network, Inc.	DE	Family Medicine Physician	$0	$2.9M
Ivonne Herrera	DE	Rheumatology Physician	$2.7M	$0
Seaford Internal Medicine LLC	DE	Internal Medicine Physician	$0	$2.7M

Alpha Care Medical, LLC — Billing Profile & Reimbursement Data

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Alpha Care Medical, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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