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.

State Of Delaware (NPI 1861528648)

Field	Value
Entity Type	Organization
Organization	State Of Delaware
Address	4550 New Linden Hill Rd
City	Wilmington
State	DE
ZIP	19808
Taxonomy	Local Education Agency (LEA)
NPI Enumerated	February 26, 2007

Payer Source	Total Paid
Medicaid	$9.2M
Medicare	$0

Key Findings

STATE OF DELAWARE is effectively a single-payer provider in this dataset: it has no Medicare billing on file and all reported program revenue comes from Medicaid, with total Medicaid revenue of $9.2M. This concentration means any analysis of its operations and payor exposure should treat Medicaid as the primary — and practically sole — revenue stream.

Revenue is highly concentrated in a very small number of Medicaid codes: the top three Medicaid codes by revenue account for 69.5% of this provider’s total Medicaid revenue, indicating that a few service lines drive the majority of cash flow. This concentration creates operational reliance on those dominant service categories and suggests limited diversification across Medicaid-reimbursed activities.

G9008 is the single largest revenue driver, with $4.7M in revenue (50.7% of the provider’s total Medicaid revenue) across 12.7K claims and an average paid/claim of $368; the provider ranks #1 of 1 in-state for this code. The prominence of G9008 (coordinated care fee / physician coordinated care oversight services) implies a central role delivering managed or coordinated care functions, likely linked to care management or oversight activities within the education agency context.

The provider also reports very large volumes for speech and communication services: 92508 ($917K, 45.9K claims, $20 avg paid/claim) and 92507 ($724.3K, 34.5K claims, $21 avg paid/claim) together represent 17.9% of total Medicaid revenue. Both codes rank at the top of state peer lists (92508 ranks #1 of 20 at the 100th percentile; 92507 ranks #1 of 27 at the 100th percentile), indicating this LEA is a major statewide provider of speech-language services for Medicaid-covered beneficiaries.

Several additional outpatient and therapy-related codes show substantial volumes consistent with an education-provider service mix: 97530 (therapeutic activities, $806.4K, ranks #5 of 79 at the 95th percentile), 97110 (therapeutic exercise, $395.2K, ranks #18 of 92 at the 81st percentile), and 97150 (group therapeutic procedures, $141.8K, ranks #3 of 22 at the 90th percentile). The pattern of these codes supports an operational profile centered on therapy and rehabilitation services delivered in group and individual formats, consistent with school-based health service models.

The provider is an extreme or pronounced outlier on multiple screening and preventive service codes relative to in-state peers: S5190 (wellness assessment) generated $325.5K and ranks #1 of 30 with the label extreme outlier, and V5008 (hearing screening) generated $200K and ranks #2 of 35 with notably above typical state volume. These screening and preventive services align with population-level school health activities and underscore the LEA’s role in routine health surveillance and early identification of needs.

Operational tenure is long: the NPI was enumerated on 2007-02-26 (approximately 19 years ago), indicating established presence and sustained participation in Medicaid billing over nearly two decades. This longevity supports interpretation of the coded service mix as stable programmatic practice rather than a short-term or experimental billing pattern.

Competitive standing by code shows dominance on several lines: the provider ranks #1 in-state for G9008, 92508, 92507 and S5190 (several at the 100th percentile or labeled extreme outlier), marking it as a leading statewide provider for coordinated care, speech-language services, and wellness assessments. For other therapy codes such as 97530 and 97110 it sits in high but not top percentiles (95th and 81st respectively), indicating strong volume for those services but with more peer activity across the state.

Medicaid: Complete Services Breakdown

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

12 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G9008	Coordinated care fee, physician coordinated care oversight services	12,650	$370	$4.7M
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	45,850	$20	$917K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	26,880	$30	$806.4K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	34,490	$20	$724.3K
T2002	Non-emergency transportation; per diem	15,120	$40	$604.7K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	9,640	$40	$395.2K
S5190	Wellness assessment, performed by non-physician	17,130	$20	$325.5K
99173	The provider checks the eyesight in both eyes of a pediatric patient by asking him to read letters of varying sizes on a standard chart, such as a Snellen’s chart, which he keeps 20 feet away from…	10,890	$20	$206.9K
T1001	Nursing assessment / evaluation	10,100	$20	$202.1K
V5008	Hearing screening	10,530	$20	$200K

Showing 1–10 of 12

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

State Of Delaware — 5 of 12 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

12 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G9008	Coordinated care fee, physician coordinated care oversight services	1	10	12,650	$370	$4.7M
T2002	Non-emergency transportation; per diem	3	10	5,750	$50	$448.8K
T1001	Nursing assessment / evaluation	4	50	1,950	$50	$294K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	1	30	2,960	$40	$284.3K
92508	The provider treats a group of two or more individuals with communication and hearing difficulties by directly interacting with them. He assesses the patients with impairment in their ability to make…	1	20	7,820	$20	$244K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	18	90	2,360	$20	$181.1K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	5	80	2,590	$20	$181.1K
V5008	Hearing screening	2	40	540	$20	$51.5K
97150	In this procedure, the provider supervises and directs therapeutic procedures like exercise therapy for a group of patients.	3	20	1,420	$20	$46.9K
S5190	Wellness assessment, performed by non-physician	1	30	570	$20	$46.4K

Showing 1–10 of 12

Nearby Providers

Other providers in the same ZIP code as State Of Delaware, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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
Jmk Behavior, LLC	DE	Intellectual & Developmental Disabilities Psychologist	$0	$2.2M

State Of Delaware — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References