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.

Nanticoke Gastroenterology, P.A. (NPI 1649311325)

Field	Value
Entity Type	Organization
Organization	Nanticoke Gastroenterology, P.A.
Address	924 Middleford Rd
City	Seaford
State	DE
ZIP	19973
Taxonomy	Gastroenterology Physician
NPI Enumerated	February 8, 2007

Payer Source	Total Paid
Medicaid	$277.5K
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,660	$60	$91K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	570	$110	$62.2K
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…	1,140	$50	$52.5K
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…	930	$40	$33.4K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	540	$50	$24.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	120	$90	$11.3K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	40	$40	$1.6K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	20	$60	$1.1K

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

Nanticoke Gastroenterology, P.A. — 1 of 8 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

8 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…	262	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…	267	540	1,100	$40	$185.3K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	25	30	490	$180	$168.8K
45380	The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include…	13	20	360	$180	$96.9K
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…	35	190	240	$60	$90.8K
45385	The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a…	11	20	70	$220	$71.8K
45378	The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush…	4	10	70	$180	$67.1K
43235	The provider inserts an endoscope through the mouth and down into the esophagus, stomach, and duodenum for diagnostic purposes; the provider may collect specimens by brushing or washing.	1	10	310	$80	$25.6K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nanticoke Gastroenterology, P.A., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bradley Mackler	DE	Gastroenterology Physician	$190.4K	$0

Nearby Providers

Other providers in the same ZIP code as Nanticoke Gastroenterology, P.A., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tidalhealth Nanticoke, Inc	DE	General Acute Care Hospital	$0	$19.2M
Dynamic Therapy Services LLC	DE	Physical Therapist	$0	$12.8M
Addiction Medical Facility, LLC	DE	Substance Abuse Rehabilitation Facility	$98.8K	$9M
Tidalhealth Physician Network, Inc.	DE	Family Medicine Physician	$0	$8.7M
Resouces For Human Development, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.4M
Ambient Medical Care, LLC	DE	Urgent Care Clinic/Center	$0	$3.3M
Lynch, Rodriguez And Keller, PA	DE	Dentist	$0	$3.3M
Tidalhealth Physician Network, Inc.	DE	Family Medicine Physician	$0	$2.9M
Ivonne Herrera	DE	Rheumatology Physician	$2.7M	$0
Seaford Internal Medicine LLC	DE	Internal Medicine Physician	$0	$2.7M

Nanticoke Gastroenterology, P.A. — Billing Profile & Reimbursement Data

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Nanticoke Gastroenterology, P.A. — 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