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NPI 1760491807 · Wilmington, DE · Family Medicine Physician
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Mayda Melendez is a family medicine physician provider located in Wilmington, Delaware. This profile covers 16 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Mayda Melendez |
| Address | 2500 W 4th St |
| City | Wilmington |
| State | DE |
| ZIP | 19805 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | August 7, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2M |
| Medicaid | $0 |
This provider is effectively single‑payer: lifetime Medicare revenue is $2M while reported Medicaid revenue is $0, indicating the practice’s Medicare business represents the entire public-payer footprint documented here. The absence of Medicaid billing suggests payer strategy, patient mix, or contracting choices that concentrate reimbursement exposure in Medicare alone.
Revenue is extremely concentrated in a very small set of codes: the precomputed top 3 Medicare codes by revenue account for 90.7% of this provider's total Medicare revenue. Those three are led by J3245 at $1.5M (77.4%), followed by J0897 at $181.4K (9.2%) and 99214 at $81K (4.1%), so a single drug and a small number of services drive most receipts.
The code mix points to a family medicine practice that operates a high-volume injectable/biologic administration service alongside routine office care. J3245 (tildrakizumab) and J0897 (denosumab) are high-volume injectable biologics and J1306 (inclisiran) also appears in the top codes; together with infusion/administration lines like 96365, this suggests on‑site medication administration and care pathways built around specialty injections rather than a pure primary‑care visit mix.
The provider is an outlier nationally for J3245: J3245 ranks #6 of 225 providers nationally (98th percentile; extreme outlier), indicating exceptionally high national standing for tildrakizumab administration. By contrast, J0897 ranks #1129 of 10057 (89th percentile; typical, unremarkable volume) and 99214 ranks #16012 of 479517 (97th percentile; notably above typical), so the practice is dominant for one biologic while also showing above‑typical volume for moderate‑complexity E/M visits.
Operational throughput is reflected in very large claim counts for injectable codes: J3245 shows 13.8K claims and J0897 shows 10.1K claims, with J1306 at 7.7K claims. These volumes imply a capacity and workflow oriented to frequent in‑office injections or infusions, requiring staff and scheduling infrastructure to support high‑frequency administration.
The provider also bills a substantial amount for remote physiologic monitoring and chronic care coordination services, including 99457 (612 claims, $22.6K revenue), 99454 (480 claims, $18.7K), 99458 (550 claims, $16.5K), and 99490 (339 claims, $17K). National ranks for these codes (for example 99457 at #725 of 6044, 88th percentile) show the practice is an active participant in RPM/CCM programs and has integrated remote monitoring into its care model at above‑typical levels.
NPI tenure is long-standing: enumerated 2006-08-07 (~20 years ago), which supports that the provider has had time to develop the staffing, referral relationships, and operational processes necessary to sustain high-volume injectable and chronic-care services. This longevity is consistent with the developed service lines suggested by the code mix.
From a business-strategy perspective, the extreme concentration in J3245 combined with sole reliance on Medicare ($2M vs. $0 Medicaid) creates material dependence on reimbursement and demand for a single biologic within the Medicare population. Any payer policy, formulary change, or shifts in utilization for J3245 would likely have outsized revenue implications for this provider given the precomputed concentration of 90.7% in the top three codes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
16 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J3245 | Injection, tildrakizumab, 1 mg | 13,800 | $110 | $1.5M |
| J0897 | Injection, denosumab, 1 mg | 10,080 | $20 | $181.4K |
| 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… | 870 | $90 | $81K |
| J1306 | Injection, inclisiran, 1 mg | 7,670 | $10 | $69K |
| 99457 | The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month and… | 610 | $40 | $22.6K |
| 99454 | The provider supplies one or more devices for remote physiologic monitoring that occurs for 16 to 30 days in a 30–day period. | 480 | $40 | $18.7K |
| 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… | 340 | $50 | $16.9K |
| 99458 | The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month.… | 550 | $30 | $16.5K |
| 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… | 360 | $40 | $13.5K |
| 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… | 140 | $60 | $8.4K |
Showing 1–10 of 16
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 16 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
16 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J3245 | 1 | 10 | 13,800 | $110 | $1.5M |
| J1306 | 3 | 10 | 8,950 | $10 | $180K |
| J0897 | 12 | 60 | 3,360 | $20 | $132.9K |
| 99214 | 149 | 1,830 | 150 | $80 | $25.5K |
| 99458 | 4 | 20 | 170 | $30 | $19.4K |
| 99457 | 7 | 20 | 170 | $40 | $18.1K |
| G0439 | 363 | 490 | 90 | $120 | $17.2K |
| 99490 | 23 | 80 | 140 | $50 | $17K |
| 99213 | 783 | 1,810 | 120 | $60 | $13.6K |
| 99454 | 6 | 20 | 180 | $40 | $12.7K |
Showing 1–10 of 16
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
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 |
|---|---|---|---|---|
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 40 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Delaware providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Delaware median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 90471 | In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route. | 76 | 100 | 230 | $1 | $6.7K |
Other providers in the same ZIP code as Mayda Melendez, ranked by combined Medicare and Medicaid revenue.
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