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.

Anthony Clay (NPI 1649202573)

Field	Value
Entity Type	Individual
Organization	Anthony Clay
Address	1 Centurian Dr
City	Newark
State	DE
ZIP	19713
Taxonomy	Cardiovascular Disease Physician
NPI Enumerated	July 7, 2006

Payer Source	Total Paid
Medicare	$1.2M
Medicaid	$0

Key Findings

The provider’s billing mix is weighted toward advanced cardiac imaging and outpatient evaluation: the top Medicare codes are 78431 (PET myocardial imaging), A9555 (Rubidium rb-82 per study dose), and 99214 (established outpatient E/M). This combination of high-value nuclear cardiology procedures together with substantial office visit volume indicates an operation that combines a cardiac imaging service line with a high-throughput clinic for evaluation and follow-up care.

Revenue is highly concentrated in a few procedures: the precomputed top three Medicare codes account for 64.1% of the provider’s total Medicare revenue, with 78431 contributing $459.5K (37.6% of Medicare revenue), 99214 contributing $178K (14.5%), and A9555 contributing $147.1K (12.0%). This concentration means a large share of the $1.2M Medicare revenue depends on a narrow set of cardiac imaging and associated visit codes.

The provider is effectively single-payer at the public program level: Medicare revenue is $1.2M while there is no Medicaid billing on file. This absence of Medicaid activity indicates the practice’s public-pay mix is concentrated in Medicare beneficiaries rather than dual Medicare/Medicaid billing.

Competitive standing for core imaging codes is mixed: 78431 ranks #102 of 1377 providers nationally (93th percentile; typical, unremarkable volume) and A9555 ranks #309 of 1266 (75th percentile; typical, unremarkable volume). Those ranks suggest the provider is a credible regional participant in PET myocardial imaging but not unusually dominant among national imaging peers.

For outpatient evaluation and several noninvasive diagnostics the provider is an outlier: 99214 ranks #1488 of 479517 (100th percentile; extreme outlier, far above typical national volume), 93880 ranks #68 of 21316 (100th percentile; extreme outlier, far above typical national volume), and 93000 ranks #422 of 71016 (99th percentile; extreme outlier, far above typical national volume). These extreme-outlier labels indicate substantially higher-than-typical volumes for office E/M, arterial duplex, and ECG/stress testing relative to national peers, consistent with a high-volume clinic workflow.

Ancillary imaging support and stress-agent usage further confirm an imaging-centered practice: J2785 (regadenoson) generated $51.3K (4.2% of Medicare revenue) and ranks #203 of 6388 (97th percentile; typical, unremarkable volume), while other radiopharmaceutical codes such as A9500 and 78452 appear in the top list. The presence of these agent and tracer codes aligns with a workflow that performs pharmacologic stress and radiotracer-based cardiac imaging rather than only consultative cardiology.

Tenure is long-standing: the NPI was enumerated on 2006-07-07 (~20 years ago), indicating the provider has been active for roughly two decades. Combined with the concentrated imaging and high E/M volumes, the long tenure suggests an established practice likely built around a steady Medicare patient base and imaging operations.

The provider’s single-payer exposure and concentrated revenue mix present both risk and strategic focus: with $1.2M in Medicare revenue and no Medicaid billing, changes to Medicare imaging or E/M reimbursement could materially affect overall revenue. Conversely, the strong national ranking for several high-volume outpatient and diagnostic codes suggests operational capacity to grow payer diversification or expand contracted services if desired.

Medicare: Complete Services Breakdown

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
78431	The provider performs a PET myocardial imaging scan, a type of nuclear imaging test, with CT transmission scan that reveals blood flow to and from the heart (perfusion). Ejection fraction and…	230	$1,970	$459.5K
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…	1,940	$90	$178K
A9555	Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries	240	$610	$147.1K
93880	Duplex scanning of arteries for the evaluation of blood flow is a type of non–invasive vascular diagnostic process. A physician can visualize and selectively assess the flow patterns of peripheral…	760	$140	$104.2K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	190	$350	$66.6K
J2785	Injection, regadenoson, 0.1 mg	1,250	$40	$51.3K
78434	The provider performs a positron emission tomography (PET) study at both rest and stress to measure myocardial blood flow. Stress is induced by injection of a drug. Report this code in conjunction…	240	$150	$34.8K
93015	The provider supervises the recording of the electrical activity of the heart to examine any abnormality in its functioning by obtaining blood pressure and electrocardiograph readings at regular…	450	$60	$25.1K
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…	180	$140	$24.4K
93978	The provider performs a complete study of the aorta, the inferior vena cava or IVC, the iliac vasculature, or bypass grafts using duplex Doppler ultrasound scanning. He performs the study to assess…	190	$130	$24.3K

Showing 1–10 of 39

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 39 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Delaware Distribution

Anthony Clay — 4 of 25 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

39 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
78431	3	10	80	$1,810	$437.6K
A9555	3	10	240	$610	$195.5K
93306	58	70	450	$100	$51.8K
78452	18	60	120	$250	$40.3K
78434	3	10	90	$140	$33.5K
J2785	5	30	390	$40	$26.9K
99214	17	1,830	150	$80	$25.5K
93880	3	80	70	$110	$16.6K
99232	250	730	120	$60	$14.2K
A9500	10	20	170	$90	$13.9K

Showing 1–10 of 39

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christiana Care Health Services, Inc.	DE	General Acute Care Hospital	$0	$99.4M
Christiana Care Health Services Inc	DE	Hospitalist Physician	$0	$13.6M
Mercy Health System Corporation	WI	Multi-Specialty Clinic/Center	$0	$13.2M
Christiana Care Health Services Inc	DE	Obstetrics & Gynecology Physician	$0	$9.9M
Christiana Care Health Services Inc	DE	Neonatal-Perinatal Medicine Physician	$0	$8.9M
Christiana Care Health Services Inc	DE	Family Medicine Physician	$0	$5.6M
Christiana Care Health Services Inc	DE	Neurology Physician	$0	$5.1M
Christiana Care Health Services, Inc	DE	Family Medicine Physician	$0	$5.1M
Christiana Care Health Services Inc	DE	Student Health Clinic/Center	$0	$3.9M
Christiana Care Health Services, Inc	DE	Psychiatry Physician	$0	$2.9M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Associated Retinal Consultants LLC	DE	Ophthalmology Physician	$0	$25.2M
Columbus Medical Services, LLC	DE	Case Management Agency	$0	$18.7M
Caritas Home Health Services, Inc	DE	Home Health Agency	$0	$11.2M
Delaware Center For Maternal Fetal Medicine Of Christiana Care	DE	Maternal & Fetal Medicine Physician	$0	$9.8M
Medical Oncology Hematology Consultants PA	DE	Hematology & Oncology Physician	$0	$7.7M
Christiana Care Quality Partners	DE	Urgent Care Clinic/Center	$0	$7M
Jamal Misleh	DE	Hematology & Oncology Physician	$6.8M	$0
Mid-atlantic Behavioral Health, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$6.5M
First State Orthopaedics, PA	DE	Orthopaedic Surgery Physician	$0	$6M
Autism Delaware	DE	Intellectual & Developmental Disabilities Psychologist	$0	$5.8M

Anthony Clay — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References