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

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

Sussex Emergency Associates LLC (NPI 1275512105)

Sussex Emergency Associates LLC is a emergency medicine physician provider located in Lewes, Delaware. This profile covers 0 Medicare and 9 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Sussex Emergency Associates LLC
Address	424 Savannah Rd
City	Lewes
State	DE
ZIP	19958
Taxonomy	Emergency Medicine Physician
NPI Enumerated	January 10, 2006

Payer Source	Total Paid
Medicaid	$4.3M
Medicare	$0

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.	29,110	$70	$2.1M
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.	29,280	$50	$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.	14,560	$30	$422.3K
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…	1,910	$120	$223.5K
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.	570	$20	$8.5K
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…	30	$60	$2K
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…	160	$1	$160
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…	490	$0	$0
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	10	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Sussex Emergency Associates LLC — 0 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

9 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	13	30	11,180	$110	$3.4M
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.	8	40	770	$110	$1.9M
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.	5	30	1,350	$110	$1.5M
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.	14	20	4,570	$120	$1.4M
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…	9	20	1,350	$120	$348.4K
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…	15	20	7,120	$10	$154.5K
71046	In this diagnostic procedure, the provider performs a minimum of two radiological views of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and…	31	30	770	$10	$70.6K
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…	13	10	110	$50	$16.2K
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…	3	10	340	$1	$440

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beebe Medical Center, Inc.	DE	General Acute Care Hospital	$0	$29.2M
Beebe Physician Network Inc.	DE	Internal Medicine Physician	$0	$19.7M
Juliano Senior Care, Inc.	DE	In Home Supportive Care Agency	$0	$5.9M
Lourdes Aponte	DE	Rheumatology Physician	$3.6M	$0
Jose Pando	DE	Rheumatology Physician	$3.2M	$0
Delaware Psychological Services LLC	DE	Mental Health Counselor	$0	$3M
The Pediatric & Adolescent Center	DE	Specialist	$0	$2.9M
Sea Haven Home Care, LLC	DE	In Home Supportive Care Agency	$0	$2.3M
Southern Delaware Imaging Assoc	DE	Diagnostic Radiology Physician	$0	$2.3M
Egnm LLC	DE	Ambulatory Surgical Clinic/Center	$2.2M	$13.6K

Sussex Emergency Associates LLC — Billing Profile & Reimbursement Data

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Sussex Emergency Associates LLC — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Arthur Pecora	NJ	Emergency Medicine Physician	$143.4K	$0
Kevin Eanes	DE	Emergency Medicine Physician	$143K	$0
Emily Sluzas	DE	Emergency Medicine Physician	$135.2K	$0
Jonathan Hilton	DE	Emergency Medicine Physician	$125.9K	$0
John Jesus	VA	Emergency Medicine Physician	$110.2K	$9.1K
Lindsay Albanese	DE	Emergency Medicine Physician	$119.2K	$0
John Dillon	DE	Emergency Medicine Physician	$115.9K	$0
Paul Cowan	DE	Emergency Medicine Physician	$107K	$0
Harold Spangler	DE	Emergency Medicine Physician	$104.8K	$0
Eric Gallagher	DE	Emergency Medicine Physician	$84.9K	$0