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.

Endocrinology Consultant PA (NPI 1659488468)

Field	Value
Entity Type	Organization
Organization	Endocrinology Consultant PA
Address	9 E Loockerman St
City	Dover
State	DE
ZIP	19901
Taxonomy	Endocrinology, Diabetes & Metabolism Physician
NPI Enumerated	August 25, 2006

Payer Source	Total Paid
Medicaid	$142.6K
Medicare	$0

Medicaid: Complete Services Breakdown

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,370	$50	$72.8K
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…	1,490	$50	$67K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	200	$10	$2.7K
1036F	N/A	130	$0	$0
3044F	The A1C test (HbA1C test) is a blood test which shows the levels of glucose (sugar) in the blood. The provider uses the test to determine if the patient’s diabetes is well controlled. The provider…	20	$0	$0
3045F	N/A	20	$0	$0
3061F	The microalbuminuria test is a urine test that measures the amount of albumin in a patient's urine. A negative test shows the absence of albumin in the urine. This shows that there is no kidney…	20	$0	$0
4004F	The provider screens a patient of 18 years of age or older for the use of tobacco. If he identifies the patient as a tobacco user, the provider offers cessation counseling or drugs or a combination…	150	$0	$0
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	110	$0	$0
G8420	Bmi is documented within normal parameters and no follow-up plan is required	20	$0	$0

Showing 1–10 of 16

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

Endocrinology Consultant PA — 0 of 3 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

16 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…	232	500	1,130	$50	$235.1K
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…	27	150	230	$90	$110.4K
95251	A provider analyzes and interprets data from a patient’s continuous glucose monitor (CGM) and writes a report based on interpretation. This code represents the professional component of the service…	5	10	440	$30	$23.3K
G8420	Bmi is documented within normal parameters and no follow-up plan is required	13	20	40	$1	$140
3044F	The A1C test (HbA1C test) is a blood test which shows the levels of glucose (sugar) in the blood. The provider uses the test to determine if the patient’s diabetes is well controlled. The provider…	22	30	200	$1	$70
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	12	20	140	$1	$60
1036F	N/A	19	30	310	$1	$50
G8753	Most recent systolic blood pressure >= 140 mmhg	3	10	110	$1	$40
G8754	Most recent diastolic blood pressure < 90 mmhg	5	10	60	$1	$40
4004F	The provider screens a patient of 18 years of age or older for the use of tobacco. If he identifies the patient as a tobacco user, the provider offers cessation counseling or drugs or a combination…	4	10	60	$1	$30

Showing 1–10 of 16

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Manveen Duggal	DE	Endocrinology, Diabetes & Metabolism Physician	$157K	$0

Nearby Providers

Other providers in the same ZIP code as Endocrinology Consultant PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayhealth Medical Center, Inc.	DE	General Acute Care Hospital	$0	$79.3M
Bayhealth Emergency Physicians LLC	DE	Emergency Medicine Physician	$0	$16.7M
Ahl And O'connor Orthodontics, LLC	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$12.5M
Bayhealth Medical Center, Inc	DE	Colon & Rectal Surgery Physician	$0	$12.4M
State Of Delaware	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$8.2M
The Children's Secret Garden	DE	Medically Fragile Infants and Children Day Care	$0	$8.1M
Apogee Medical Group, Delaware, Inc	DE	Internal Medicine Physician	$0	$7.9M
First State Oral And Maxillofacial Surgery Corp	DE	Oral and Maxillofacial Surgery (Dentist)	$0	$5M
Jamie Ahl	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$4.9M
Kent Diagnostic Radiology Associates PA	DE	Diagnostic Radiology Physician	$0	$4.6M

Endocrinology Consultant PA — Billing Profile & Reimbursement Data

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Endocrinology Consultant PA — 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