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.

First State Medical Associates (NPI 1699806257)

Field	Value
Entity Type	Organization
Organization	First State Medical Associates
Address	2055 Limestone Rd
City	Wilmington
State	DE
ZIP	19808
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 7, 2007

Payer Source	Total Paid
Medicaid	$1.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	21,050	$40	$757.7K
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…	6,030	$40	$265.3K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	1,710	$80	$133.6K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	910	$80	$69.7K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	1,150	$10	$6.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	1,340	$10	$6.7K
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…	110	$40	$4K
99386	The provider performs a well–patient visit for a patient who is between the ages of 40 and 64.	130	$30	$3.9K
99442	N/A	100	$40	$3.7K
99496	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…	30	$110	$2.9K

Showing 1–10 of 32

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

First State Medical Associates — 1 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

32 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…	108	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…	24	540	1,100	$40	$185.3K
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…	114	190	240	$60	$90.8K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	12	50	160	$70	$51.1K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	8	50	170	$70	$41.4K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	30	40	910	$10	$27.5K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	141	180	180	$20	$24.4K
93000	The provider records the electrical conduction of the heart to examine any abnormality in its functioning, based on signals from at least 12 leads, wires that connect the recording device to…	38	50	390	$10	$22.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	32	110	340	$10	$20.4K
99386	The provider performs a well–patient visit for a patient who is between the ages of 40 and 64.	5	10	50	$100	$17.4K

Showing 1–10 of 32

Related Providers

Other providers that share a Tax Identification Number (TIN) with First State Medical Associates, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Marcia Gina Castro	DE	Internal Medicine Physician	$101K	$0

Nearby Providers

Other providers in the same ZIP code as First State Medical Associates, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
State Of Delaware	DE	Local Education Agency (LEA)	$0	$9.2M
Jp Nacchia & Associates, Inc.	DE	In Home Supportive Care Agency	$0	$8.2M
Macklyn Home Care	DE	Home Health Agency	$0	$6.2M
Journeys LLC	DE	Mental Health Counselor	$0	$5M
Resouces For Human Development, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$4.3M
Robert M Collins Dds PA	DE	Pediatric Dentistry	$0	$3.2M
Regional Orthopaedic Associates PA	DE	Orthopaedic Surgery Physician	$0	$2.8M
Rockland Surgery Center, L.P.	DE	Anesthesiology Physician	$2.4M	$280K
Limestone Medical Center, LLC	DE	Ambulatory Surgical Clinic/Center	$2.3M	$242.7K
Pace, Inc.	DE	Adult Mental Health Clinic/Center	$0	$2.3M

First State Medical Associates — 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