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

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

Nems PLLC (NPI 1114482882)

Field	Value
Entity Type	Organization
Organization	Nems PLLC
Address	435 Lewis Ave
City	Meriden
State	CT
ZIP	06451
Taxonomy	Emergency Medicine Physician
NPI Enumerated	February 6, 2019

Payer Source	Total Paid
Medicaid	$6.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 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.	50,330	$70	$3.6M
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.	36,290	$50	$1.9M
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.	21,570	$30	$582.5K
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…	460	$90	$39.9K
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…	80	$70	$5.7K
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…	30	$160	$3.9K
99235	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…	10	$80	$1.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	20	$1	$50
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	20	$1	$20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Connecticut Distribution

Nems PLLC — 0 of 9 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Connecticut

Full comparison — all codes billed, vs. Connecticut median

9 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.	19	130	520	$330	$5.9M
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.	32	130	690	$180	$4.7M
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.	36	110	1,520	$140	$3.4M
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…	48	80	790	$240	$650K
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…	54	90	130	$60	$89.5K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	71	70	1,230	$1	$72K
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…	12	20	50	$150	$44.7K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	58	70	130	$10	$6K
99235	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…	7	10	40	$80	$5K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Nems PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Debra Campbell	CT	Emergency Medicine Physician	$83.1K	$0
Vanessa Brown	CT	Emergency Medicine Physician	$40.7K	$2.7K
Stephanie Veillette	CT	Physician Assistant	$22.2K	$0

Nearby Providers

Other providers in the same ZIP code as Nems PLLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Midstate Medical Center	CT	General Acute Care Hospital	$0	$110.8M
Hunter's Ambulance Service, Inc.	CT	Ambulance	$4.2M	$25.5M
Emergency Medicine Physicians Of New Haven County,llc	CT	Emergency Medicine Physician	$0	$8.6M
Midstate Gastroenterology Specialists PC	CT	Gastroenterology Physician	$0	$6.6M
Midstate Radiology Associates, LLC	CT	Diagnostic Radiology Physician	$0	$6.6M
B.e.k Eyecare, Inc	CT	Optometrist	$0	$3.7M
Apple Dental And Associates,llc	CT	General Practice Dentistry	$0	$2.1M
Connecticut Counseling Centers, Inc	CT	Methadone Clinic	$0	$2M
Franciscan Family Care Center, Inc.	CT	Home Health Agency	$0	$1.8M
Midstate Medical Center	CT	General Acute Care Hospital	$0	$1.3M

Nems PLLC — Billing Profile & Reimbursement Data

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Nems PLLC — 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