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.

Rheumatology Center Of Delaware, LLC (NPI 1447308168)

Field	Value
Entity Type	Organization
Organization	Rheumatology Center Of Delaware, LLC
Address	260 Beiser Blvd Ste 201
City	Dover
State	DE
ZIP	19904
Taxonomy	Rheumatology Physician
NPI Enumerated	January 8, 2007

Payer Source	Total Paid
Medicaid	$4.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

25 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	750	$2,430	$1.8M
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	1,150	$810	$930.6K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	440	$1,730	$764.6K
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…	8,450	$40	$346.4K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	4,060	$70	$279.9K
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…	3,240	$80	$252.9K
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…	1,960	$110	$207.5K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	240	$810	$197.4K
A4221	Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately)	3,250	$10	$35.7K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	400	$80	$32.5K

Showing 1–10 of 25

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

Rheumatology Center Of Delaware, LLC — 2 of 19 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

25 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J1745	Injection, infliximab, excludes biosimilar, 10 mg	3	10	580	$2,340	$1.6M
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	1	10	390	$2,400	$945K
Q5104	Injection, infliximab-abda, biosimilar, (renflexis), 10 mg	1	10	1,150	$810	$930.7K
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	1	10	440	$1,730	$764.8K
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…	156	500	1,130	$50	$235.1K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	3	10	2,240	$70	$186.3K
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…	68	540	1,100	$40	$185.3K
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…	27	180	220	$90	$101.5K
20610	In this procedure, the provider inserts a needle through the skin of a patient and into a major joint or bursa and then uses the syringe attachment to the needle to remove fluid or he may inject a…	10	10	1,860	$20	$90K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	37	70	180	$20	$66.8K

Showing 1–10 of 25

Related Providers

Other providers that share a Tax Identification Number (TIN) with Rheumatology Center Of Delaware, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maged Hosny	DE	Rheumatology Physician	$3.1M	$0
Linda Ashley	DE	Nurse Practitioner	$21.9K	$0
Debra Lynch	DE	Gerontology Nurse Practitioner	$12.7K	$0

Nearby Providers

Other providers in the same ZIP code as Rheumatology Center Of Delaware, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$37.9M
At Home Infucare, LLC	DE	Home Health Agency	$0	$28.5M
Amazing Home Care Agency	DE	Home Health Agency	$0	$18.7M
Dedicated To Women Ob-gyn, P.A.	DE	Obstetrics & Gynecology Physician	$0	$11.1M
Help At Home Of Delaware, LLC	DE	In Home Supportive Care Agency	$0	$10.7M
A Center For Mental Wellness, Inc.	DE	Mental Health Counselor	$0	$9.9M
State Of Delaware	DE	Case Management Agency	$0	$9.2M
West Dover Dental, LLC	DE	Dentist	$0	$9M
Americare Home Solutions	DE	In Home Supportive Care Agency	$0	$8.4M
Vicdania Health Services LLC	DE	Home Health Agency	$0	$7.4M

Rheumatology Center Of Delaware, LLC — Billing Profile & Reimbursement Data

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Rheumatology Center Of Delaware, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References