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.

Southbridge Medical Advisory Council Inc (NPI 1770699621)

Field	Value
Entity Type	Organization
Organization	Southbridge Medical Advisory Council Inc
Address	601 New Castle Ave
City	Wilmington
State	DE
ZIP	19801
Taxonomy	Federally Qualified Health Center (FQHC)
NPI Enumerated	August 22, 2006

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	12,690	$150	$1.9M
T1015	Clinic visit/encounter, all-inclusive	4,930	$30	$167.4K
G0466	Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more…	920	$140	$125K
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	100	$130	$12.8K
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…	5,220	$1	$5.2K
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…	4,540	$1	$4.5K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	50	$60	$2.9K
D0150	Comprehensive oral evaluation – new or established patient	30	$70	$1.9K
D0330	N/A	10	$90	$1.1K
D0140	Limited oral evaluation – problem focused	10	$50	$660

Showing 1–10 of 30

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

Southbridge Medical Advisory Council Inc — 0 of 15 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	5	20	2,490	$170	$2.9M
G0470	Federally qualified health center (fqhc) visit, mental health, established patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between an established patient and a fqhc…	6	10	2,020	$160	$604.9K
G0466	Federally qualified health center (fqhc) visit, new patient; a medically-necessary, face-to-face encounter (one-on-one) between a new patient and a fqhc practitioner during which time one or more…	3	10	910	$170	$379.8K
T1015	Clinic visit/encounter, all-inclusive	11	50	1,490	$80	$340.7K
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…	131	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…	115	540	1,100	$40	$185.3K
D0120	Periodic oral evaluation - established patient	149	160	800	$40	$110.5K
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…	66	150	230	$90	$110.4K
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…	158	190	240	$60	$90.8K
D1110	Prophylaxis - adult; cleaning and polishing of the teeth	133	160	330	$60	$82.3K

Showing 1–10 of 30

Related Providers

Other providers that share a Tax Identification Number (TIN) with Southbridge Medical Advisory Council Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southbridge Medical Advisory Council, Inc.	DE	Federally Qualified Health Center (FQHC)	$0	$364.4K
Southbridge Medical Advisory Council Inc	DE	Federally Qualified Health Center (FQHC)	$0	$124.6K
Cheryl Bolinger	DE	Family Medicine Physician	$52.5K	$0
Tina Solomon	DE	Nurse Practitioner	$24.2K	$0
Charles Case	DE	Family Medicine Physician	$440	$0
Yvette Gbemudu	DE	Family Medicine Physician	$340	$0

Nearby Providers

Other providers in the same ZIP code as Southbridge Medical Advisory Council Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Christiana Care Health Services, Inc.	DE	General Acute Care Hospital	$0	$99.4M
Connections Csp, Inc.	DE	Intellectual & Developmental Disabilities Psychologist	$0	$28.5M
Neighborly Home Care	DE	In Home Supportive Care Agency	$0	$21.5M
Caring Angels Homecare Agency, Inc.	DE	Home Health Agency	$0	$21M
Delaware Guidance Services For Children & Youth, Inc.	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$15.4M
State Of De	DE	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$13.1M
Christiana Care Health Services Inc	DE	Family Medicine Physician	$0	$5.6M
Crescent Dental, LLC	DE	Dentist	$0	$5.1M
Christiana Care Health Services, Inc	DE	Psychiatry Physician	$0	$2.9M
Steps Center LLC	DE	Home Health Agency	$0	$2.9M

Southbridge Medical Advisory Council Inc — Billing Profile & Reimbursement Data

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Southbridge Medical Advisory Council Inc — 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