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 Virginia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Virginia 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. Virginia (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.

Emergency Physicians Of Tidewater (NPI 1033136841)

Field	Value
Entity Type	Organization
Organization	Emergency Physicians Of Tidewater
Address	6379 Center Dr
City	Norfolk
State	VA
ZIP	23502
Taxonomy	Emergency Medicine Physician
NPI Enumerated	July 16, 2006

Payer Source	Total Paid
Medicaid	$47.9M
Medicare	$0

Key Findings

This practice has no Medicare billing on file and reports $47.9M in lifetime Medicaid revenue, making its public billing footprint effectively single‑payer with Medicaid as the dominant source of reimbursed services. The absence of Medicare payments in the dataset is notable and should be treated as either a true payer mix concentration or a data limitation to confirm with contracting records.

Revenue is extremely concentrated in a very small set of emergency E/M codes: the top three Medicaid codes (99285, 99284, 99283) together account for 94.2% of the provider's total Medicaid revenue. Individually those codes generate $24.7M (51.6%) for 99285, $16.3M (34.0%) for 99284, and $4.2M (8.7%) for 99283, demonstrating that high‑acuity and moderate‑acuity ED visits drive the vast majority of payments.

The code mix (primary reliance on 99285, 99284, 99283, plus secondary utilization of 99291 and 93010) identifies EMERGENCY PHYSICIANS OF TIDEWATER as an emergency department–focused group with a marked tilt toward higher‑acuity care. High counts for ED E/M codes and presence of critical care (99291) and procedures such as intubation (31500) and incision and drainage (10061/10060) indicate on‑site acute care, airway management, and minor surgical procedures consistent with 24/7 ED coverage.

On competitive standing within Virginia this provider is a statewide outlier for ED E/M volumes: 99285 ranks #2 of 340 providers (100th percentile; extreme outlier) and 99284 ranks #2 of 620 providers (100th percentile; extreme outlier), while 99283 ranks #5 of 626 providers (99th percentile; extreme outlier). These rank/percentile signals show the group is a dominant Medicaid provider for high‑acuity emergency visits in‑state rather than a modest participant.

Critical care and observation/hospital throughput are present but represent smaller shares of revenue: 99291 contributes $1.4M (2.9%) and ranks #4 of 134 providers (98th percentile; extreme outlier), while 99236 contributes $258.1K (0.5%) and ranks #1 of 7 providers (100th percentile; notably above typical state volume). This mix suggests the group not only manages ED arrivals but also bills for time‑intensive critical care and same‑day inpatient/observation encounters when clinically indicated.

Ancillary and procedure codes generate limited incremental revenue relative to E/M: 93010 (ECG interpretation) appears at scale with 173.2K claims and $692.6K revenue (1.4%) and ranks #3 of 282 providers (99th percentile; extreme outlier), but most procedural codes (for example 31500 at $1.4K, 10061 at $48.8K) are small contributors to total Medicaid revenue. In operational terms this means clinical staffing, ED throughput, and E/M documentation/triage capacity will drive margin and performance more than procedural throughput.

The extreme concentration in a few ED codes (94.2% of Medicaid revenue from the top three codes) creates high sensitivity to changes in Medicaid policy, coding guidance, or payer rates for those specific E/M codes. For payers and contracting analysts this profile signals that negotiating on ED E/M rates or modifying coverage/case management around ED utilization could materially affect the provider's revenue stream.

The NPI has been enumerated since 2006-07-16 (~20 years ago), indicating long tenure in the market; combined with the provider's statewide high percentile ranks on multiple ED codes, this suggests an established operational presence in Norfolk and the surrounding Virginia Medicaid market. Longevity plus dominant code volumes supports classification as a long‑standing, high‑volume emergency medicine provider in the state Medicaid ecosystem.

Medicaid: Complete Services Breakdown

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

26 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	271,160	$90	$24.7M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	271,000	$60	$16.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	126,130	$30	$4.2M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	12,320	$110	$1.4M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	173,160	$1	$692.6K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	1,970	$130	$258.1K
99220	N/A	1,320	$80	$109.7K
99217	N/A	1,700	$40	$61.3K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	440	$110	$48.8K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	430	$110	$47.3K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Virginia providers billing the same CPT/HCPCS codes.

Claims Volume vs. Virginia Distribution

Emergency Physicians Of Tidewater — 6 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Virginia

Full comparison — all codes billed, vs. Virginia median

26 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	2	340	160	$130	$1.3M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	5	630	90	$140	$1.1M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	88	140	3,240	$160	$1M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2	620	70	$120	$1M
99281	The provider sees a patient for the lowest level emergency department visit.	58	100	610	$160	$242.1K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	4	130	440	$120	$197K
93308	The provider performs a limited or follow–up transthoracic echocardiography to obtain a two dimensional (2D) image of the heart through the chest wall. It is a limited examination of a focused…	29	30	70	$330	$194.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	96	280	140	$80	$105K
99220	N/A	7	40	260	$60	$81.7K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	22	80	170	$190	$66.8K

Showing 1–10 of 26

Related Providers

Other providers that share a Tax Identification Number (TIN) with Emergency Physicians Of Tidewater, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joel Michael	VA	Emergency Medicine Physician	$113.7K	$9.4K
Benjamin Blackwood	NH	Emergency Medicine Physician	$75.6K	$36.7K
James Wilson	VA	Emergency Medicine Physician	$98.8K	$11.6K
Stewart Martin	VA	Emergency Medicine Physician	$107.2K	$540
Colleen Corbett	VA	Medical Physician Assistant	$93.5K	$0
Daniel Mccormack	VA	Emergency Medicine Physician	$78K	$13.6K
Autumn Graham	DC	Emergency Medicine Physician	$83.1K	$0

Nearby Providers

Other providers in the same ZIP code as Emergency Physicians Of Tidewater, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Sentara Hospitals	VA	General Acute Care Hospital	$0	$79.7M
Tremont Road Dental Super, P.C.	VA	General Practice Dentistry	$0	$63.5M
Sentara Medical Group	VA	Family Medicine Physician	$0	$48.7M
Community Alternative Inc	VA	Community/Behavioral Health Agency	$0	$44.3M
Life's Journey	VA	Adult Mental Health Clinic/Center	$0	$24.4M
Keys To Success Family & Developmental Services	VA	Community/Behavioral Health Agency	$0	$16.1M
Advantage Home Care, LLC	VA	Home Health Agency	$0	$15.7M
National Counseling Group, Inc	VA	Mental Health Counselor	$0	$14.5M
Childrens Medical Group Inc	VA	Pediatrics Physician	$0	$9.1M
Pediatric Services Of America, LLC	VA	Nursing Care Agency	$0	$9.1M

Emergency Physicians Of Tidewater — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References