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 Maryland for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Maryland 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. Maryland (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.

Tidalhealth Specialty Care, LLC (NPI 1619504735)

Tidalhealth Specialty Care, LLC is a medical specialty clinic/center provider located in Salisbury, Maryland. This profile covers 0 Medicare and 98 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	Tidalhealth Specialty Care, LLC
Address	100 E Carroll St
City	Salisbury
State	MD
ZIP	21801
Taxonomy	Medical Specialty Clinic/Center
NPI Enumerated	March 26, 2020

Payer Source	Total Paid
Medicaid	$11.7M
Medicare	$0

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

98 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…	51,890	$70	$3.7M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	11,850	$100	$1.1M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	18,760	$40	$806.7K
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…	16,440	$50	$789K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	27,870	$30	$752.4K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	9,560	$70	$707.5K
99220	N/A	5,120	$110	$543K
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…	4,140	$80	$331.4K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	6,370	$40	$280.3K
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…	940	$290	$272.7K

Showing 1–10 of 98

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maryland providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maryland Distribution

Tidalhealth Specialty Care, LLC — 15 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maryland

Full comparison — all codes billed, vs. Maryland median

98 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…	22	3,670	680	$90	$310K
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…	149	3,280	610	$80	$296.1K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	42	110	300	$90	$225.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	13	300	420	$50	$213.2K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	14	420	600	$40	$182.1K
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…	19	40	860	$110	$166.9K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	7	160	340	$70	$139.2K
99220	N/A	4	50	550	$80	$106.8K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	24	40	460	$80	$103.6K
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…	60	1,000	200	$120	$96.3K

Showing 1–10 of 98

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Justin Kucinski	MD	Internal Medicine Physician	$6.9M	$0
Tanya Clifford	MD	Nurse Practitioner	$2.9M	$0
Ivonne Herrera	DE	Rheumatology Physician	$2.7M	$0
Rabindra Paul	MD	Infectious Disease Physician	$2.1M	$0
David Chung	MD	Diagnostic Ultrasound Physician	$1.1M	$0
John Mansueti	MD	Radiation Oncology Physician	$960.8K	$0
Osamuyimen Igbinosa	DC	Internal Medicine Physician	$278.3K	$641.7K
Mark Treuth	MD	Interventional Cardiology Physician	$905.6K	$0
Manoj Jain	MD	Radiation Oncology Physician	$695.5K	$0
Gerard Hogan	MD	Body Imaging Physician	$631.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Service Associates PA	MD	Emergency Medicine Physician	$0	$24.6M
Hudson Health Services, Inc.	MD	Substance Abuse Rehabilitation Facility	$0	$23.1M
Bnj Health Services Inc Salisbury	MD	Substance Use Disorder Rehabilitation Clinic/Center	$0	$10.3M
Tidalhealth Peninsula Regional, Inc.	MD	General Acute Care Hospital	$0	$7.6M
Ydiprmc LLC	MD	Urgent Care Clinic/Center	$0	$7.3M
Cnp Operating Co LLC	MD	Multi-Specialty Clinic/Center	$0	$7.3M
Cove Recovery, LLC	MD	Addiction (Substance Use Disorder) Counselor	$0	$5.2M
Gateway Pediatrics, LLC	MD	Pediatrics Physician	$0	$5.1M
Go-getters Inc	MD	Community/Behavioral Health Agency	$0	$5M
Wicomico County Health Department	MD	Public Health or Welfare Agency	$0	$4.9M

Tidalhealth Specialty Care, LLC — Billing Profile & Reimbursement Data

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Tidalhealth Specialty Care, 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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