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.

Delaware Medical Care PA (NPI 1447234232)

Delaware Medical Care PA is a internal medicine physician provider located in Smyrna, Delaware. This profile covers 0 Medicare and 29 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	Delaware Medical Care PA
Address	51 Deak Dr
City	Smyrna
State	DE
ZIP	19977
Taxonomy	Internal Medicine Physician
NPI Enumerated	December 5, 2005

Payer Source	Total Paid
Medicaid	$812.8K
Medicare	$0

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

29 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…	10,370	$60	$601.5K
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…	3,130	$40	$128.3K
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…	360	$100	$34.9K
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…	180	$100	$19K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	190	$70	$12.4K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	790	$10	$4.7K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	380	$10	$3.4K
90756	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no antibiotics, and is administered as a 0.5 mL injection into…	180	$20	$3.1K
90688	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It uses split virus technology and is given as a 0.5 mL dose.	730	$1	$2.2K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	50	$50	$2.1K

Showing 1–10 of 29

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

Delaware Medical Care PA — 1 of 16 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

29 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…	55	500	1,130	$50	$235.1K
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…	155	540	1,100	$40	$185.3K
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…	57	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…	99	180	220	$90	$101.5K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	41	50	160	$70	$51.1K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	25	50	170	$70	$41.4K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	26	50	390	$10	$22.1K
J1885	Injection, ketorolac tromethamine, per 15 mg	13	20	810	$1	$21.5K
99442	N/A	54	70	110	$30	$14.1K
96127	The provider performs a brief emotional/behavioral assessment of the patient using a standardized instrument (such as a recognized form). The provider scores and documents the assessment.	98	110	270	$1	$11.4K

Showing 1–10 of 29

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Interim Healthcare Of Delaware LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$51.8M
The Smile Place	DE	Dentist	$0	$11.6M
Maxim Healthcare Services, Inc.	DE	Home Health Agency	$0	$7.3M
Little Tooth Doctors LLC	DE	Pediatric Dentistry	$0	$939.2K
Christiana Care Health Services Inc	DE	Urgent Care Clinic/Center	$0	$649.1K
Connections Community Support Programs, Inc.	DE	Adolescent and Children Mental Health Clinic/Center	$0	$615.1K
American Legion Ambulance Station 64 Inc	DE	Land Ambulance	$438.8K	$121.4K
Deborah Kirk	DE	Family Medicine Physician	$403.7K	$0
Deakyne, Dental Associates, P.A.	DE	General Practice Dentistry	$0	$401.1K
State Of Delaware	DE	Local Education Agency (LEA)	$0	$399.6K

Delaware Medical Care PA — Billing Profile & Reimbursement Data

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Delaware Medical Care PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Islam Al Junaidi	DE	Internal Medicine Physician	$222.6K	$0
Nadiene Haynes	DE	Family Medicine Physician	$70.9K	$0