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

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

Shadow Emergency Physicians PLLC (NPI 1184795874)

Field	Value
Entity Type	Organization
Organization	Shadow Emergency Physicians PLLC
Address	620 Shadow Ln
City	Las Vegas
State	NV
ZIP	89106
Taxonomy	Emergency Medicine Physician
NPI Enumerated	November 13, 2006

Payer Source	Total Paid
Medicaid	$75.2M
Medicare	$0

Key Findings

SHADOW EMERGENCY PHYSICIANS PLLC is effectively a single-payer Medicaid operation in the available claims data: there is no Medicare billing on file and all reported federal revenue is from Medicaid totaling $75.2M. This concentration means the provider’s observable revenue footprint is driven entirely by Medicaid activity in the dataset rather than a split payer mix.

Revenue is extremely concentrated in a narrow set of ED E/M codes: the top three Medicaid codes (99285, 99284, 99283) account for 98.0% of the provider’s total Medicaid revenue. Specifically, 99285 represents $50.7M (67.5% of total Medicaid revenue), 99284 represents $16.4M (21.8%), and 99283 represents $6.5M (8.7%), indicating that a very small code set drives nearly all reported Medicaid dollars.

The code mix and volumes indicate an emergency-department–centric service line with a strong tilt toward high-acuity visits: 99285 (high level E/M) shows 419.3K claims at $121 avg paid/claim for $50.7M revenue, and 99284 (moderate level E/M) shows 195.2K claims at $84 avg paid/claim for $16.4M revenue. These claim counts and payments are consistent with a facility-level ED operation handling very large patient throughput and a large share of higher-acuity presentations.

State-level competitive standing for core ED services is dominant: the provider ranks #1 of 352 for 99285 and #1 of 398 for 99284 (both listed as 100th percentile; extreme outlier), and ranks #3 of 390 for 99283 (99th percentile; extreme outlier). In plain terms, this entity is a major outlier in Nevada Medicaid for ED E/M activity and sits at the top of in-state volume for the highest- and moderate-acuity ED codes.

Ancillary cardiac monitoring and interpretation are billed at very high volume but represent a small share of revenue, consistent with ED workflow billing: 93010 appears 148.7K times at $5 avg paid/claim for $743.6K (1.0% of Medicaid revenue) and 93042 appears 46.9K times at $1 avg paid/claim for $46.9K (0.1% of revenue); both are ranked at or near the 100th percentile in-state and described as extreme outliers. These items suggest routine EKG interpretation is a frequent, low-dollar component of encounters that accompanies the high-volume ED E/M activity.

Critical care and time-based ED critical-care billing are present but constitute a small share of revenue: 99291 has 4.4K claims at $163 avg paid/claim for $710.4K (0.9% of Medicaid revenue) and ranks #12 of 87 (87th percentile; typical). This pattern indicates that while true critical-care-level services are billed, they do not drive the practice’s Medicaid revenue the way high-acuity ED E/M codes do.

There are notable reporting anomalies in non‑revenue items: 99053 (overnight services) appears 24.8K times with $0 avg paid/claim and $0 revenue (0.0% of Medicaid revenue) and ranks #3 of 136 (99th percentile; extreme outlier). The dataset shows these claims were reported frequently but generated no paid dollars in the Medicaid extract, which is a material feature of the provider’s recorded activity even if it does not contribute to revenue totals.

The provider has an established tenure in federal enrollment, with the NPI enumerated on 2006-11-13 (~20 years ago). Combined with the very large Medicaid volumes and top in-state ranks, this longevity supports interpretation of the patterns as sustained operational scale rather than a short-term reporting artifact.

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.	419,300	$120	$50.7M
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.	195,180	$80	$16.4M
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.	125,800	$50	$6.5M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	148,720	$10	$743.6K
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…	4,360	$160	$710.4K
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	46,860	$1	$46.9K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	220	$10	$1.5K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	70	$1	$70
99053	The provider renders overnight services at a 24 hour facility.	24,810	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nevada Distribution

Shadow Emergency Physicians PLLC — 5 of 8 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nevada

Full comparison — all codes billed, vs. Nevada 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.	1	350	240	$110	$685.4K
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	400	200	$90	$442.5K
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…	12	90	190	$160	$332.4K
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	390	200	$60	$289.8K
71045	In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby…	194	210	640	$10	$54.6K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	2	210	200	$1	$21.9K
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	1	40	180	$1	$4.4K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	33	120	70	$1	$1.8K
99053	The provider renders overnight services at a 24 hour facility.	3	140	120	$1	$40

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Clark County Department Of Family Services	NV	Case Management Agency	$0	$166.5M
Valley Hospital Medical Center	NV	General Acute Care Hospital	$0	$47M
Southwest Medical Associates, Inc	NV	Diagnostic Radiology Physician	$418.3K	$15.8M
Las Vegas Paiute Tribe Health & Human Services	NV	General Practice Physician	$0	$13.6M
Fresenius Medical Care West Sahara, LLC	NV	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$12.2M
Bridge Counseling Associates, Inc	NV	Community/Behavioral Health Agency	$0	$12.1M
Iriye Medical Group PLLC	NV	Maternal & Fetal Medicine Physician	$0	$11.9M
Janda, Mahajan & Balsiger PLLC	NV	Neurology Physician	$0	$10.5M
Behavioral Health Institute Inc (singh) PC	NV	Addiction Medicine (Family Medicine) Physician	$0	$9.8M
Pulmonary Associates, Inc.	NV	Pulmonary Disease Physician	$0	$8.5M

Shadow Emergency Physicians PLLC — Billing Profile & Reimbursement Data

Sign up for Shadow Emergency Physicians PLLC — Billing Profile & Reimbursement Data policy alerts

Shadow Emergency Physicians PLLC — Billing Profile & Reimbursement Data

Sign up for Shadow Emergency Physicians PLLC — Billing Profile & Reimbursement Data policy alerts

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