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

Why is the Medicaid comparison limited to North Carolina 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. North Carolina (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.

Wake Forest Emergency Providers (NPI 1396216735)

Field	Value
Entity Type	Organization
Organization	Wake Forest Emergency Providers
Address	557 Brookdale Dr
City	Statesville
State	NC
ZIP	28677
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	December 11, 2018

Payer Source	Total Paid
Medicaid	$48.7M
Medicare	$0

Key Findings

WAKE FOREST EMERGENCY PROVIDERS reports no Medicare billing on file and $48.7M in lifetime Medicaid revenue, making its commercial/Medicare exposure effectively nil in this dataset and its operations functionally single-payer (Medicaid) for the observed claims. This payer mix means analyses of financial performance and utilization should be interpreted primarily through Medicaid reimbursement rules and local managed-Medicaid arrangements rather than Medicare benchmarks.

Revenue is highly concentrated in a very small set of emergency department E/M codes: 99284 accounts for 56.6% of Medicaid revenue, 99285 accounts for 36.3%, and 99283 accounts for 5.8%, with the precomputed top-3 codes together accounting for 98.7% of total Medicaid revenue. That concentration indicates the provider’s Medicaid revenue is almost entirely driven by ED evaluation-and-management encounters, creating sensitivity to coding, authorization, or reimbursement changes affecting those specific E/M levels.

The code mix (99284, 99285, 99283) and the high claim volumes reflect an emergency-department–centric operation focused on moderate- and high-complexity E/M throughput. The prominence of 99285 (high medical decision making) and 99284 (moderate medical decision making) suggests the group routinely manages acutely ill patients requiring significant evaluation and interventions typical of hospital-affiliated or freestanding emergency practice models.

Competitive standing in-state is dominant for the two highest-revenue ED codes: 99284 ranks #1 of 325 providers in North Carolina (100th percentile; flagged as an extreme outlier), and 99285 ranks #1 of 281 providers in the state (100th percentile; extreme outlier). 99283 ranks #21 of 316 (94th percentile; notably above typical state volume), indicating the practice is a major statewide player for Medicaid ED E/M services rather than a modest participant.

Operational throughput is apparent in absolute claim counts and per-claim reimbursement levels: 99284 shows 372.4K claims at $74 avg paid/claim, 99285 shows 210.7K claims at $84 avg paid/claim, and 99283 shows 69.2K claims at $41 avg paid/claim. These volumes, combined with the average paid-per-claim differences, explain how a relatively small set of codes can generate $48.7M in Medicaid revenue and point to very high visit volumes per year.

Ancillary and critical-care billing patterns are present but not revenue-dominant: 93010 appears at 99.2K claims with $3 avg paid/claim and $297.5K revenue (0.6% of Medicaid revenue) and ranks #6 of 243 (98th percentile; extreme outlier), consistent with routine ECG interpretation tied to ED throughput. 99291 shows 2.7K claims at $117 avg paid/claim and $315.7K revenue (0.6% of Medicaid revenue) and ranks #16 of 144 (90th percentile; typical, unremarkable), indicating intermittent critical-care level encounters that do not materially drive revenue.

The provider’s state-level outlier status on several codes (two 100th-percentile extreme outliers and at least one 98th-percentile extreme outlier) should inform competitive and network analyses: payers and analysts should treat this entity as an unusually large source of Medicaid ED volume in its market, which has implications for network adequacy, budget impact, and contract negotiations. At the same time, the extreme concentration in a narrow set of ED codes represents a single-service exposure from a revenue risk perspective.

WAKE FOREST EMERGENCY PROVIDERS was enumerated on 2018-12-11 (~8 years ago), indicating it reached its current high Medicaid volumes within a relatively recent operating window. Given its short-tenure enumeration and the rapid accumulation of state-leading volumes, stakeholders should consider timeline-based analyses (month/year trends) to assess whether the current concentration and volumes reflect steady-state operations or rapid growth/market consolidation.

Medicaid: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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.	372,390	$70	$27.6M
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.	210,740	$80	$17.7M
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.	69,220	$40	$2.8M
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…	2,700	$120	$315.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	99,160	$1	$297.5K
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…	20	$120	$1.7K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. North Carolina Distribution

Wake Forest Emergency Providers — 3 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — North Carolina

Full comparison — all codes billed, vs. North Carolina median

6 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	330	6,130	$130	$2.7M
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.	21	320	6,160	$120	$2.1M
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	280	2,690	$130	$1.6M
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…	16	140	150	$120	$128.3K
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…	259	280	130	$90	$80.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	6	240	1,280	$1	$33.1K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Wake Forest Emergency Providers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Otis Speight	SC	Emergency Medicine Physician	$683.6K	$0
Irene Childress	NC	Nurse Practitioner	$214.1K	$1.7K
Todd Hansen	FL	Phlebology Physician	$123.7K	$0
Aaron Schmitt	NC	Emergency Medicine Physician	$119.9K	$0
Mary Corey	NC	Physician Assistant	$74.8K	$0
John Wlezniak	MI	Emergency Medicine Physician	$68K	$0
Hisham Bassiouni	SC	Physician Assistant	$60.4K	$0
Dillon Casey	NC	Emergency Medicine Physician	$40.4K	$0
Abby Fesperman	NC	Physician Assistant	$30.9K	$0
Anne Herion	NC	Physician Assistant	$19.8K	$0

Nearby Providers

Other providers in the same ZIP code as Wake Forest Emergency Providers, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Barium Springs Home For Children	NC	Foster Care Agency	$0	$19.3M
Iredell Memorial Hospital, Incorporated	NC	General Acute Care Hospital	$0	$12.7M
Easter Seals Ucp North Carolina & Virginia, Inc.	NC	Community/Behavioral Health Agency	$0	$10.6M
Strategic Interventions, LLC	NC	Community/Behavioral Health Agency	$0	$7.9M
County Of Iredell	NC	Land Ambulance	$2M	$4.9M
Duncan Mccall	NC	Rheumatology Physician	$478.2K	$0
Naveed Rajper	NC	Interventional Cardiology Physician	$231K	$5.9K
Ashma Davidson	NC	Primary Podiatric Medicine Podiatrist	$235K	$0
Jips Zachariah	NC	Interventional Cardiology Physician	$219.7K	$0
William White	NC	Internal Medicine Physician	$192.4K	$0

Wake Forest Emergency Providers — Billing Profile & Reimbursement Data

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Wake Forest Emergency Providers — 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