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.

James Spellman (NPI 1609864982)

Field	Value
Entity Type	Individual
Organization	James Spellman
Address	18947 John J Williams Hwy
City	Rehoboth Beach
State	DE
ZIP	19971
Taxonomy	Surgical Oncology Physician
NPI Enumerated	October 11, 2005

Payer Source	Total Paid
Medicare	$25.5K
Medicaid	$0

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	110	$70	$7K
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,…	130	$40	$4.9K
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…	30	$120	$4.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	60	$50	$3.2K
11602	The provider excises a cancerous (malignant) lesion, including margins, of 1.1 to 2.0 cm in diameter, from the skin of the trunk, arms, or legs.	10	$200	$2.8K
11601	The provider excises a cancerous (malignant) lesion, including margins, of 0.6 to 1.0 cm or less in diameter, from the skin of the trunk, arms, or legs.	10	$170	$2.3K
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…	10	$90	$940

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

James Spellman — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. state median

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99213	929	1,810	120	$60	$13.6K
99204	477	950	30	$110	$6.5K
99203	646	670	40	$70	$5.3K
11602	24	30	30	$90	$4.5K
99212	73	480	30	$40	$3.1K
11601	2	10	20	$160	$3K
99202	23	100	20	$50	$2.2K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Coastal Kids Pediatric Dentistry, LLC	DE	Pediatric Dentistry	$0	$9.7M
Beacon Pediatrics LLC	DE	Pediatrics Physician	$0	$3.7M
Ams Of Delaware, LLC	DE	Substance Use Disorder Rehabilitation Hospital Unit	$123.6K	$3.3M
Nouman Asif	DE	Hematology & Oncology Physician	$1.5M	$0
Delaware Eye Surgery Center, LLC	DE	Ambulatory Surgical Clinic/Center	$1.3M	$20.1K
Charles Curry	DE	Ophthalmology Physician	$605.3K	$0
Rehoboth Beach Volunteer Fire Co., Inc.	DE	Ambulance	$459.2K	$62.8K
Scott Fudemberg	DE	Ophthalmology Physician	$353.5K	$0
Arthur Belson	DE	Ophthalmology Physician	$316.3K	$0
Matthew Tulloch	DE	Family Medicine Physician	$257K	$0

James Spellman — Billing Profile & Reimbursement Data

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James Spellman — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References