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.

Mid-atlantic Pain Institute, P.A. (NPI 1831148410)

Mid-atlantic Pain Institute, P.A. is a interventional pain medicine physician provider located in Newark, Delaware. This profile covers 0 Medicare and 46 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	Mid-atlantic Pain Institute, P.A.
Address	100 Biddle Ave
City	Newark
State	DE
ZIP	19702
Taxonomy	Interventional Pain Medicine Physician
NPI Enumerated	May 9, 2006

Payer Source	Total Paid
Medicaid	$959.9K
Medicare	$0

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

46 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	19,740	$30	$513.3K
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…	6,150	$30	$196.8K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	4,220	$50	$190.1K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	3,160	$1	$12.6K
95923	In this procedure, the provider tests the sudomotor function of the autonomic nervous system to check functioning of nerves that supply sweat glands. The autonomic nervous system is that part of the…	140	$60	$9.1K
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	900	$10	$7.2K
93922	Noninvasive physiologic studies of upper or lower extremity arteries, single level, bilateral	130	$40	$5.6K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	190	$30	$5K
95921	The provider evaluates the function of the autonomic nervous system, which controls those body functions, such as heart rate, temperature regulation, and other functions that are involuntary. He uses…	140	$30	$4.9K
95911	In this procedure, the provider performs nine or ten nerve conduction studies, a diagnostic test to evaluate function, especially the electrical conduction ability of the motor and sensory nerves of…	30	$130	$3.4K

Showing 1–10 of 46

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

Mid-atlantic Pain Institute, P.A. — 2 of 20 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

46 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	9	10	1,330	$70	$462.8K
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…	26	500	1,130	$50	$235.1K
96138	A technician administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of administration and scoring by any method.	3	10	230	$20	$194.4K
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…	99	540	1,100	$40	$185.3K
99204	The provider sees a new 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 provider…	90	180	220	$90	$101.5K
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	3	10	3,390	$30	$79.8K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	39	70	180	$20	$66.8K
95886	The provider assesses the electrical activity of a muscle in the extremity and related paraspinal areas. At the same session as a separately reportable nerve conduction study. He studies five or more…	7	10	240	$80	$55.7K
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…	32	50	390	$10	$22.1K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	16	20	3,550	$1	$19.3K

Showing 1–10 of 46

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jason Brajer	PA	Pain Medicine (Anesthesiology) Physician	$642.5K	$620
Nikhil Verma	IL	Sports Medicine (Orthopaedic Surgery) Physician	$113.8K	$0
Melissa Hindle	MD	Certified Registered Nurse Anesthetist	$67.8K	$0
Nikhil Verma	OH	Physical Medicine & Rehabilitation Physician	$26.6K	$0
David Mwaura	MD	Certified Registered Nurse Anesthetist	$6.2K	$4.6K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mosaic	DE	Mental Illness Community Based Residential Treatment Facility	$0	$118.5M
Community Systems, Inc.	DE	Intellectual & Developmental Disabilities Psychologist	$0	$96.7M
Resources For Human Development Inc.	DE	Intellectual & Developmental Disabilities Psychologist	$0	$86M
Epic Health Services (de), LLC	DE	Home Health Agency	$0	$33.7M
Jay J Harris Dmd PC	DE	Dentist	$0	$16.7M
Elite Home Health Care Inc	DE	In Home Supportive Care Agency	$0	$14.8M
Accredo Health Group Inc	DE	Pharmacy	$0	$10.2M
Bear-glasgow Dental, LLC	DE	General Practice Dentistry	$0	$8.2M
Center For Child Development, Incorporated	DE	Psychologist	$0	$4.9M
Comfort Care At Home, Inc.	DE	Home Health Agency	$0	$4M

Mid-atlantic Pain Institute, P.A. — Billing Profile & Reimbursement Data

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Mid-atlantic Pain Institute, P.A. — 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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