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.

Herman Ortez (NPI 1437514908)

Field	Value
Entity Type	Individual
Organization	Herman Ortez
Address	3301 Green St Ste 241
City	Claymont
State	DE
ZIP	19703
Taxonomy	Professional Counselor
NPI Enumerated	December 28, 2015

Payer Source	Total Paid
Medicaid	$180.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,260	$80	$180.6K

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

Herman Ortez — 0 of 1 code 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

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	70	240	700	$60	$205.6K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Triad Ministry Inc	DE	Community/Behavioral Health Agency	$0	$97.7K

Nearby Providers

Other providers in the same ZIP code as Herman Ortez, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Conexio Care, Inc.	DE	Intellectual & Developmental Disabilities Psychologist	$0	$37.9M
Conexio Care, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$12M
State Of Delaware	DE	Local Education Agency (LEA)	$0	$1.5M
Ats Of Delaware, LLC	DE	Methadone Clinic	$190.3K	$1.1M
Claymont Family Dentistry	DE	Dental Clinic/Center	$0	$968.9K
Claymont Fire Company 1	DE	Land Ambulance	$351.7K	$421.5K
Ivyrehab Delaware LLC	DE	Physical Medicine & Rehabilitation Physician	$0	$750.7K
Bc Home Healthcare Services, Inc.	DE	Home Health Agency	$0	$441.6K
Southbridge Medical Advisory Council, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$364.4K
Patricia Manchak	DE	Physical Therapist	$315.6K	$0

Herman Ortez — Billing Profile & Reimbursement Data

Sign up for Herman Ortez — Billing Profile & Reimbursement Data policy alerts

Herman Ortez — Billing Profile & Reimbursement Data

Sign up for Herman Ortez — 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