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.

Mac Physicians LLC (NPI 1699108951)

Mac Physicians LLC is a general practice physician provider located in Hockessin, Delaware. This profile covers 0 Medicare and 20 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	Mac Physicians LLC
Address	5936 Limestone Rd Ste 301b
City	Hockessin
State	DE
ZIP	19707
Taxonomy	General Practice Physician
NPI Enumerated	August 9, 2013

Payer Source	Total Paid
Medicaid	$391.6K
Medicare	$0

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

20 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	1,210	$70	$88.3K
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…	1,510	$40	$55.7K
96116	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for the first hour of face–to–face…	920	$60	$51.5K
96133	The provider, a physician or other qualified healthcare professional, administers neuropsychological tests, face–to–face with the patient. Report this code in addition to the primary code (96132) for…	790	$50	$42.6K
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…	270	$100	$26.6K
92548	The provider performs computerized dynamic posturography sensory organization testing to evaluate the patient's motor, sensory, and integrative processes used to maintain balance and stability. The…	430	$60	$25.7K
99354	N/A	780	$30	$25.7K
99355	N/A	780	$30	$24.1K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	290	$80	$22.5K
96113	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for each additional 30 minutes of…	250	$30	$8.5K

Showing 1–10 of 20

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

Mac Physicians LLC — 7 of 19 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

20 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92548	The provider performs computerized dynamic posturography sensory organization testing to evaluate the patient's motor, sensory, and integrative processes used to maintain balance and stability. The…	2	10	4,430	$60	$249.1K
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…	230	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…	329	540	1,100	$40	$185.3K
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…	67	150	230	$90	$110.4K
99439	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	7	10	920	$30	$60.1K
96116	A physician or other qualified healthcare professional performs a face–to–face assessment of a patient’s thinking, reasoning, and judgment. Report this code for the first hour of face–to–face…	1	10	700	$80	$55K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	5	10	230	$90	$52.6K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	25	30	440	$20	$39.1K
96132	The provider, a physician or other qualified healthcare professional, spends up to one hour administering neuropsychological tests, which includes time spent face–to–face with the patient in…	1	10	280	$80	$33.9K
92060	The basic eye sensorimotor exam checks the alignment of the eyes and their ability to move together in eight fields of gaze ( up, down, right, left, up–left, up–right, down–left, down–right) and…	6	10	770	$30	$33.9K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christiana Care Health Services, Inc	DE	Family Medicine Physician	$0	$5.1M
Matthews Dental Associates, PA	DE	Dentist	$0	$1.8M
Regal Heights Healthcare & Rehab Center, LLC	DE	Skilled Nursing Facility	$0	$410.3K
Shabbir Naqvi	DE	Body Imaging Physician	$348.3K	$0
Alessandro Bianchi	DE	Family Medicine Physician	$302.6K	$0
Guy Webster	DE	Dermatology Physician	$283.2K	$0
Performance Physical Therapy, Inc	DE	Physical Therapy Clinic/Center	$0	$262.9K
Walgreen Co.	DE	Pharmacy	$254.9K	$0
Hockessin Fire Company	DE	Ambulance	$244.1K	$7.3K
Family Practice Of Hockessin, P.A.	DE	Family Medicine Physician	$0	$232.7K

Mac Physicians 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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