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 Medicine Associates P.A., P.C. (NPI 1134117393)

Key Findings

Field	Value
Entity Type	Organization
Organization	Emergency Medicine Associates P.A., P.C.
Address	3300 Gallows Rd
City	Falls Church
State	VA
ZIP	22042
Taxonomy	Emergency Medicine Physician
NPI Enumerated	October 12, 2005

Payer Source	Total Paid
Medicaid	$85.6M
Medicare	$0

This entity is effectively single‑payer in the federal programs: Total Medicare revenue is none (no Medicare billing on file), while Total Medicaid revenue is $85.6M, indicating Medicaid is the dominant public payer for this group. Analysts should treat Medicaid patterns as the primary window into this provider’s scale and service mix because there is no Medicare activity to compare against.

Revenue is highly concentrated in a narrow set of emergency department E/M services: the top 3 Medicaid codes (99285, 99284, 99283) account for 87.6% of the provider's total Medicaid revenue. Those three codes individually generate $34.4M (99285), $34.2M (99284), and $6.1M (99283), demonstrating that high‑ and moderate‑complexity ED visits are the principal revenue drivers.

The code mix signals a high‑volume emergency medicine operation with significant downstream inpatient/critical care involvement: dominant codes 99285 and 99284 are ED E/M visits with high and moderate medical decision making respectively, and substantial billing for critical care services such as 99291 ($2.6M, 3.0% of Medicaid revenue) and inpatient subsequent care codes like 99233 ($3.7M, 4.3%). Together these entries indicate the group provides both front‑end ED care and immediate higher‑acuity follow‑up or critical care services rather than only low‑acuity walk‑in care.

Statewide competitive standing is extreme for multiple codes: the provider ranks #1 in‑state and is labeled an "extreme outlier" for 99285 (rank #1 of 340, 100th percentile), 99284 (rank #1 of 620, 100th percentile), 99233 (rank #1 of 285, 100th percentile), and 99291 (rank #1 of 134, 100th percentile). These rank/percentile patterns show the group is a dominant Medicaid billing entity in Virginia for high‑acuity ED and critical care CPTs and sits far above typical state volume for those services.

Beyond core E/M work, the provider bills a range of ancillary ED/inpatient services that support an emergency medicine operating model: examples include EKG interpretation 93010 ($118.9K), incision and drainage 10061 ($83.6K), and overnight facility services 99053 ($40.4K). While none of these individually approach the top E/M revenues, their presence confirms on‑site procedural capability and around‑the‑clock operations consistent with a staffed emergency department.

There is repeated evidence of unusually high documentation and quality‑measure activity in Medicaid claims: preventive/documentation codes such as G8427 ($343.1K) and G9744 ($202.7K) rank #1 in‑state and are labeled extreme outliers, and blood pressure documentation codes G8952 ($68.3K) and G8950 ($66.3K) also rank at the top. This pattern suggests systematic capture of measure‑related codes at scale within the group’s workflows, which may reflect standardized charting and heavy Medicaid patient volume.

Although the provider shows statewide dominance on many high‑value codes, several codes reflect more typical volume levels: for example, 99232 ($586.2K) ranks #25 of 398 (94th percentile) and 93010 ranks #23 of 282 (92nd percentile). These mid‑to‑high percentile rankings indicate the organization’s exceptional concentration is strongest on select high‑acuity ED and critical care codes, while other related services track more closely with large but not unparalleled in‑state peers.

The provider has a long active tenure in national enrollment records, with NPI enumerated on 2005-10-12 (~21 years ago). That extended registration, combined with the concentrated and high‑volume Medicaid billing profile, is consistent with an established emergency medicine group that operates at scale within its state public payer market.

Medicaid: Complete Services Breakdown

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

72 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.	354,340	$100	$34.4M
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.	510,590	$70	$34.2M
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.	161,790	$40	$6.1M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	93,640	$40	$3.7M
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…	26,560	$100	$2.6M
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…	18,310	$70	$1.2M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	17,510	$40	$665.3K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	21,710	$30	$586.2K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	171,560	$1	$343.1K
99220	N/A	4,320	$60	$250.5K

Showing 1–10 of 72

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 Medicine Associates P.A., P.C. — 17 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

72 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.	1	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.	3	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.	86	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.	1	620	70	$120	$1M
99281	The provider sees a patient for the lowest level emergency department visit.	51	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…	1	130	440	$120	$197K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	25	400	370	$30	$162.2K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1	290	360	$50	$160.1K
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…	5	280	140	$80	$105K
99220	N/A	3	40	260	$60	$81.7K

Showing 1–10 of 72

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Naveed Shah	RI	Pulmonary Disease Physician	$1.4M	$0
Laeeq Butt	VA	Internal Medicine Physician	$942.5K	$0
Arvind Narasimhan	MD	Emergency Medicine Physician	$461.7K	$0
Michael Tolino	MD	Pulmonary Disease Physician	$373.5K	$0
Alemeshet Gudeta	MD	Internal Medicine Physician	$296.1K	$0
Michele Irons	VA	Internal Medicine Physician	$289.9K	$0
Robert Loya	MD	Medical Physician Assistant	$234.6K	$0
Srilatha Kanumuru	MD	Internal Medicine Physician	$223.3K	$0
Linz Audain	VA	Internal Medicine Physician	$200.2K	$0
Michael Antonis	VA	Sports Medicine (Emergency Medicine) Physician	$185.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Inova Health Care Services	VA	General Acute Care Hospital	$0	$176.6M
American Care Partners At Home Inc	VA	In Home Supportive Care Agency	$0	$87.4M
Inova Health Care Services	VA	Internal Medicine Physician	$0	$38M
Dominion Home Health Care LLC	VA	Home Health Agency	$0	$22.1M
Ne Virginia Emergency Physicians LLC	VA	Emergency Medicine Physician	$0	$15.5M
Fairfax Radiological Consultants	VA	Specialist	$0	$10.8M
American Anesthesiology Of Virginia PC	VA	Anesthesiology Physician	$0	$8.9M
Fairfax County Public Schools	VA	Local Education Agency (LEA)	$0	$8.2M
Capital Hospice	VA	Community Based Hospice Care Agency	$0	$5.8M
Inova Health Care Services	VA	Magnetic Resonance Imaging (MRI) Clinic/Center	$1.6M	$2.9M

Emergency Medicine Associates P.A., P.C. — Billing Profile & Reimbursement Data

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Emergency Medicine Associates P.A., P.C. — 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