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.

State Of Delaware (NPI 1669977930)

Field	Value
Entity Type	Organization
Organization	State Of Delaware
Address	1054 S Governors Ave
City	Dover
State	DE
ZIP	19904
Taxonomy	Case Management Agency
NPI Enumerated	March 28, 2018

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

Key Findings

The provider’s billing profile is dominated by targeted case management services: the taxonomy is Case Management Agency and the sole listed Medicaid code is T2023 (Targeted case management; per month), indicating the organization’s core operation is recurring, per-member case management rather than episodic medical procedures. This suggests staffing and workflows oriented around ongoing care coordination and monthly service delivery rather than inpatient or procedure-based care.

Medicaid revenue is highly concentrated: the provider reports $9.2M in total Medicaid revenue and T2023 alone accounts for $9.2M and is listed as 100.0% of this provider’s total Medicaid revenue. The precomputed top-3 share is 100.0%, confirming that virtually all Medicaid billing and payment flows through a very narrow set of Medicaid codes centered on monthly case management.

This entity is effectively single-payer in practice: there is no Medicare billing on file, and all recorded reimbursement is from Medicaid. The absence of Medicare revenue means analyses of Medicare utilization or cross-payer strategy are not supported by the available billing data; the provider should be treated as Medicaid-focused in competitive and financial comparisons.

Volume and unit economics show a high-volume, low-unit-rate model: T2023 activity is 62.1K claims at an average paid amount of $148 per claim. Because T2023 is billed per month, the combination of large claim counts and modest per-claim payment is consistent with a scale-driven revenue model that depends on maintaining many ongoing member engagements.

Competitive standing within the state is modest: T2023 ranks #2 of 2 providers in-state with a 0th percentile placement and is described as "typical, unremarkable volume for this code." That ranking and descriptor indicate the provider is not a dominant statewide player in targeted case management and its activity levels fall within expected norms rather than representing an outlier.

Provider tenure is established but not long-standing: the NPI was enumerated on 2018-03-28 (~8 years ago), indicating multiple years of participation in Medicaid billing but not the multi-decade footprint seen with some larger community providers. This tenure supports a history of steady program billing without implying long legacy market dominance.

The single-code revenue concentration creates strategic and financial vulnerability: with 100.0% of Medicaid revenue tied to T2023, any policy, rate, or eligibility change affecting targeted case management reimbursement could materially affect total revenue. From a payer oversight and contracting perspective, this profile suggests the provider’s financial health and service delivery should be monitored for sensitivity to reimbursement or authorization changes.

Statistically, activity is not labeled as an outlier: the dataset characterizes the provider’s T2023 volume as "typical, unremarkable volume for this code," and no other Medicaid or Medicare codes are on file to suggest atypical billing patterns. This supports a working conclusion that utilization patterns fall within in-state norms for targeted case management rather than indicating anomalous service intensity.

Medicaid: Complete Services Breakdown

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

1 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T2023	Targeted case management; per month	62,120	$150	$9.2M

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

State Of Delaware — 0 of 1 code 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

1 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T2023	Targeted case management; per month	2	10	152,700	$90	$13.9M

Nearby Providers

Other providers in the same ZIP code as State Of Delaware, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bayada Home Health Care, Inc.	DE	Home Health Agency	$0	$37.9M
At Home Infucare, LLC	DE	Home Health Agency	$0	$28.5M
Amazing Home Care Agency	DE	Home Health Agency	$0	$18.7M
Dedicated To Women Ob-gyn, P.A.	DE	Obstetrics & Gynecology Physician	$0	$11.1M
Help At Home Of Delaware, LLC	DE	In Home Supportive Care Agency	$0	$10.7M
A Center For Mental Wellness, Inc.	DE	Mental Health Counselor	$0	$9.9M
West Dover Dental, LLC	DE	Dentist	$0	$9M
Americare Home Solutions	DE	In Home Supportive Care Agency	$0	$8.4M
Vicdania Health Services LLC	DE	Home Health Agency	$0	$7.4M
Reliable Aid, Inc	DE	Personal Care Attendant	$0	$6.4M

State Of Delaware — Billing Profile & Reimbursement Data

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State Of Delaware — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References