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

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

Professional Emergency Physicians PC (NPI 1144215096)

Key Findings

Field	Value
Entity Type	Organization
Organization	Professional Emergency Physicians PC
Address	2200 Randallia Drive
City	Fort Wayne
State	IN
ZIP	46805
Taxonomy	Emergency Medicine Physician
NPI Enumerated	September 16, 2005

Payer Source	Total Paid
Medicaid	$39.1M
Medicare	$0

PROFESSIONAL EMERGENCY PHYSICIANS PC is effectively a Medicaid-centered practice: there is no Medicare billing on file and the provider reports $39.1M in Medicaid revenue, indicating Medicaid is the sole recorded payer driving its billed volumes. This concentrated payer profile means analyses of utilization and reimbursement should be focused on Medicaid fee schedules and managed-Medicaid contracts rather than Medicare trends.

Revenue is highly concentrated in three emergency department E/M codes: 99285 ($19M, 48.7%), 99284 ($14.9M, 38.0%), and 99283 ($4.6M, 11.7%), which together account for 98.3% of the provider’s total Medicaid revenue. That extreme concentration suggests the organization’s business model is almost entirely built around ED evaluation-and-management encounters rather than a broad mix of procedures or ancillary services.

The code mix (dominance of 99285, 99284, 99283) points to a high-volume emergency department operation that bills across the full spectrum of ED acuity levels; 99285 represents high-complexity visits while 99284 and 99283 represent moderate- and low-complexity ED evaluation and management. Operational implications include the need for ED staffing, triage and throughput processes aligned to large numbers of unscheduled acute visits, and dependence on accurate E/M documentation and coding practices.

State-level competitive standing on core ED codes is dominant: 99285 ranks #3 of 325 providers in-state (99th percentile; extreme outlier) and 99284 ranks #3 of 382 providers in-state (99th percentile; extreme outlier), with 99283 at #6 of 364 providers (99th percentile; extreme outlier). These ranks indicate the provider is a major statewide player for ED E/M volume, far above typical state peers for the same codes.

Ancillary ED services appear concentrated but modest relative to E/M revenue: 93010 (ECG interpretation) shows 117.2K claims and $585.9K revenue (1.5% of Medicaid revenue) and ranks #6 of 285 providers in-state (98th percentile; extreme outlier), suggesting routine ECG interpretation is a high-frequency, low-reimbursing adjunct to the core ED visits. In contrast, higher-intensity critical care billing (99291) is present but limited: 428 claims, $37.2K (0.1%), ranked #58 of 140 (59th percentile; typical, unremarkable volume).

The provider’s revenue profile creates concentration risk: with 98.3% of Medicaid revenue from three ED E/M codes, any Medicaid reimbursement policy change, audit focus, or contract adjustment affecting ED E/M valuation could materially affect total revenue. Analysts should prioritize contract terms and utilization trends for 99285/99284/99283 when modeling near-term revenue sensitivity.

Operational nuance is evident within otherwise high volume: lower-acuity codes such as 99282 and procedure-level codes (e.g., wound repair 12001, I&D 10060/10061) appear in the mix but represent vanishing shares of revenue and rank at or near typical peer percentiles. This pattern reinforces that the practice’s scale is driven by frequency of ED E/M encounters rather than by procedural or specialty revenue streams.

The practice has a long tenure in the NPI file (enumerated 2005-09-16, ~21 years ago), which, combined with its unusually high state rankings on ED codes, suggests an established presence in the regional emergency care market. For competitive analysis, this longevity plus 99th-percentile volumes on core ED codes implies entrenched patient flow or contracting arrangements with area hospitals or payers that sustain high Medicaid ED volume.

Medicaid: Complete Services Breakdown

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

11 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.	260,880	$70	$19M
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.	235,870	$60	$14.9M
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.	127,330	$40	$4.6M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	117,180	$10	$585.9K
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…	430	$90	$37.2K
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.	1,540	$20	$30.7K
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…	260	$1	$1K
29125	The provider applies a static, or rigid, splint to the lower arm extending from the elbow to the palm to immobilize an injury to the forearm or wrist during healing or for stabilization of a fracture…	60	$10	$280
10060	The provider incises the area of abscess and drains the collection of pus from a lesion, such as a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	80	$1	$160
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…	130	$1	$130

Showing 1–10 of 11

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Professional Emergency Physicians PC — 4 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

11 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	3	380	2,470	$100	$1.5M
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.	6	360	3,490	$110	$1.5M
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.	3	330	1,530	$100	$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.	54	200	280	$130	$321.2K
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…	58	140	270	$130	$195.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	6	290	630	$1	$45.5K
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…	6	10	80	$60	$15K
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…	4	10	110	$10	$1.3K
29125	The provider applies a static, or rigid, splint to the lower arm extending from the elbow to the palm to immobilize an injury to the forearm or wrist during healing or for stabilization of a fracture…	3	10	50	$10	$460
10060	The provider incises the area of abscess and drains the collection of pus from a lesion, such as a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	6	10	60	$1	$420

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
John Kamau	OH	Emergency Medicine Physician	$81.4K	$0
Wael Azer	NJ	Emergency Medicine Physician	$78.9K	$0
Russell Mcune	ID	Emergency Medicine Physician	$25.8K	$0
Makoto Tanigawa	DC	Emergency Medicine Physician	$21.2K	$0
Tyler Warnecke	IN	Physician Assistant	$7.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Park Center, Inc.	IN	Community/Behavioral Health Agency	$0	$49.9M
Park Center Inc	IN	Psychiatric Hospital	$0	$26.7M
Park Center Inc	IN	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$26.6M
Am Home Health Care, Inc	IN	Home Health Agency	$0	$14.8M
Center For Behavioral Health Indiana LLC	IN	Methadone Clinic	$252.3K	$12.3M
Crossroad Child & Family Services, Inc.	IN	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.6M
Anthony Medical Associates P C	IN	Family Medicine Physician	$0	$3.9M
Parkview Hospital, Inc.	IN	Air Ambulance	$0	$3.8M
Midwest Eye Consultants, P.C.	IN	Optometrist	$0	$3.6M
Transcend Orthotics & Prosthetics, LLC	IN	Prosthetic/Orthotic Supplier	$0	$3M

Professional Emergency Physicians PC — Billing Profile & Reimbursement Data

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Professional Emergency Physicians PC — 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