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

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

Southeastern Emergency Physicians LLC (NPI 1356379382)

Key Findings

Field	Value
Entity Type	Organization
Organization	Southeastern Emergency Physicians LLC
Address	989 Medical Park Dr
City	Maysville
State	KY
ZIP	41056
Taxonomy	Emergency Medicine Physician
NPI Enumerated	June 29, 2006

Payer Source	Total Paid
Medicaid	$208.5M
Medicare	$0

SOUTHEASTERN EMERGENCY PHYSICIANS LLC is effectively a single‑payer Medicaid billing operation: it shows no Medicare billing on file and $208.5M in total Medicaid revenue. The absence of Medicare claims combined with the large Medicaid total indicates the group’s patient mix and revenue base are heavily concentrated in Medicaid programs rather than traditional Medicare populations.

Revenue concentration is extremely high: the precomputed top 3 Medicaid codes (99285, 99284, 99283) account for 98.2% of the provider’s total Medicaid revenue. This indicates the business is overwhelmingly driven by a very small set of emergency department E/M services rather than a broad mix of procedure or ancillary revenues.

The code mix points to a high-volume emergency department model with a distribution across acuity levels. The top three codes are ED E/M visits—99285 (high complexity), 99284 (moderate complexity), and 99283 (low complexity)—which together account for the bulk of activity and revenue, consistent with an organization working primarily in emergency care rather than outpatient primary care or specialty procedural services.

Competitive standing within Kentucky is dominant for core ED codes: 99285 ranks #1 of 239 providers in-state (100th percentile; extreme outlier), 99284 ranks #1 of 282 providers in-state (100th percentile; extreme outlier), and 99283 ranks #1 of 284 providers in-state (100th percentile; extreme outlier). Those rank and percentile labels signal this group is far above typical state volume for ED E/M services and functions as a major statewide player for emergency visit billing.

Operational detail: 99053 (overnight services) shows 289.8K claims with $0 revenue and ranks #1 of 26 providers in-state (100th percentile; extreme outlier). The combination of extremely high claim volume for 99053 and the dominant ED E/M codes suggests the practice provides continuous 24‑hour emergency coverage at scale, with a large volume of shift/overnight events captured administratively even when they do not generate direct paid revenue.

Clinical intensity indicators beyond ED E/M are present but represent small revenue shares. 99291 (critical care) appears with 10.4K claims and $831.7K revenue and ranks #9 of 158 providers in-state (95th percentile; notably above typical), indicating some level of critical care/acute management capacity within encounters handled by the group, while inpatient E/M codes such as 99223, 99233 and discharge codes appear at modest volumes and revenues.

Ancillary diagnostic codes are present but minor contributors to revenue: 93010 (ECG) has 337.1K claims for $1.7M (0.8% of Medicaid revenue) and ranks #1 of 222 providers in-state (100th percentile; extreme outlier), while chest and abdominal X‑ray codes (71046, 71045, 74019) show notable claim volumes but collectively contribute a trivial share of total Medicaid revenue. This pattern is consistent with ED workflows that bundle many low‑paid diagnostic services around high-volume E/M encounters.

Tenure and continuity: the NPI was enumerated on 2006-06-29 (~20 years ago), which suggests long-standing presence in the market. The combination of long tenure and the provider’s outsized state rankings on core ED codes implies an established operational footprint and high market penetration for emergency services in Kentucky.

Medicaid: Complete Services Breakdown

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

22 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.	1,315,230	$70	$90.8M
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.	1,446,580	$60	$83.9M
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.	752,200	$40	$30.1M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	337,110	$10	$1.7M
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…	10,400	$80	$831.7K
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…	2,430	$120	$296.9K
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…	4,460	$60	$281K
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…	3,910	$70	$269.7K
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…	3,140	$50	$141.1K
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…	11,740	$1	$47K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Kentucky Distribution

Southeastern Emergency Physicians LLC — 4 of 21 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Kentucky

Full comparison — all codes billed, vs. Kentucky median

22 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.	1	280	7,150	$150	$3M
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	240	4,710	$150	$2.6M
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.	1	280	5,700	$120	$2M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	4	10	120	$250	$878.8K
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.	101	160	2,900	$110	$610.8K
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	160	420	$140	$270.5K
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…	90	230	4,930	$20	$255.7K
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…	142	470	770	$20	$188.2K
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…	49	330	1,400	$30	$156.7K
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…	51	290	520	$30	$156.6K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Memorial Medical Group Inc	TN	Internal Medicine Physician	$0	$35.6M
Southeastern Emergency Physicians Of Memphis LLC	IL	Emergency Medicine Physician	$0	$26.5M
Clark Emergency Physicians	KY	Emergency Medicine Physician	$0	$6.7M
Baptist Minor Medical Centers Inc	TN	Internal Medicine Physician	$0	$3M
Yalobusha General Hospital	MS	General Acute Care Hospital	$0	$2.5M
Yalobusha General Hospital	MS	Rural Health Clinic/Center	$0	$1.8M
Philip Mcdonald	FL	Diagnostic Radiology Physician	$444.3K	$42.8K
Emily Langlois	KY	Nurse Practitioner	$450.3K	$0
Sherif Shoukry	VA	Emergency Medicine Physician	$122.2K	$301.7K
Abdolreza Rabiee	KY	Emergency Medicine Physician	$377.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Buffalo Trace Area Development District	KY	Supports Brokerage Agency	$0	$36.1M
Meadowview Regional Medical Center LLC	KY	Rural Acute Care Hospital	$0	$22.5M
Comprehend Inc Regional Mental Health- Mental Retardation Board Inc	KY	Community/Behavioral Health Agency	$0	$20.7M
Buffalo Trace Area Development District	KY	Supports Brokerage Agency	$0	$14.1M
Raghuraman Srinivasan	KY	Interventional Cardiology Physician	$298.4K	$695.8K
Mason County	KY	Land Ambulance	$264.7K	$657.8K
Kyle Ferguson	KY	Ophthalmology Physician	$128.5K	$458.2K
Idowu Awosika	KY	Optometrist	$30.6K	$546.1K
George Gallenstein	KY	Family Medicine Physician	$136.8K	$320.3K
William Barrett	KY	Nephrology Physician	$119.4K	$66.3K

Southeastern Emergency Physicians LLC — Billing Profile & Reimbursement Data

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Southeastern Emergency Physicians LLC — 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