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NPI 1437105277 · Alton, IL · Emergency Medicine Physician
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Southeastern Emergency Physicians Of Memphis LLC is a emergency medicine physician provider located in Alton, Illinois. This profile covers 0 Medicare and 10 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Southeastern Emergency Physicians Of Memphis LLC |
| Address | 1 Memorial Dr |
| City | Alton |
| State | IL |
| ZIP | 62002 |
| Taxonomy | Emergency Medicine Physician |
| NPI Enumerated | May 25, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $26.5M |
| Medicare | $0 |
This entity has no Medicare billing on file and reports $26.5M in lifetime Medicaid revenue, making its public reimbursement footprint effectively single-payer (Medicaid) based on available data. Analysts should treat Medicaid as the primary and dominant payer when evaluating this provider's financial footprint and contracting leverage.
Revenue is highly concentrated in three emergency department E/M codes: 99284 ($10.5M, 39.4%), 99285 ($10.3M, 39.0%), and 99283 ($5.3M, 20.0%), which together account for 98.5% of the provider's Medicaid revenue. This extreme concentration means changes in reimbursement, utilization policy, or coding guidance for these specific ED E/M services would move the vast majority of this provider's reported revenue.
The code mix (99284, 99285, 99283) and the large claim counts (145.3K claims for 99284; 113.7K claims for 99285; 120.8K claims for 99283) identify the organization as an emergency medicine practice focused on high-volume ED evaluation and management encounters across low, moderate, and high levels of medical decision making. The presence of critical care billing (99291) and overnight facility services (99053) further suggests coverage of acute and after-hours care rather than a clinic-based, scheduled-care model.
On competitive standing within the state, the provider is a clear outlier for core ED codes: it ranks #1 in-state and in the 100th percentile (extreme outlier) for 99284, 99285, and 99283, meaning its Medicaid volume for these services is far above typical state peers. For payer strategy and network negotiations, this profile indicates market dominance in emergency E/M throughput in its service area rather than a modest local participant.
Critical care services (99291) are present but represent a small share of revenue: 1.8K claims, $245.2K revenue (0.9% of total Medicaid revenue), and the code ranks #47 of 998 providers in-state (95th percentile; typical, unremarkable volume for this code). This pattern indicates occasional delivery of higher-intensity care consistent with emergency work but not a primary revenue driver compared with ED E/M codes.
Overnight coverage is a measurable line item: 99053 shows 27K claims and $107.8K revenue (0.4% of total) and ranks #1 of 131 providers in-state (100th percentile; extreme outlier). That high-ranked overnight activity supports an operational model that includes 24-hour facility staffing or contracted coverage for nights and suggests a material commitment to round‑the‑clock ED services.
Ancillary emergency services such as ECG interpretation (93010) appear at scale: 11.5K claims, $46K revenue (0.2% of total), ranking #39 of 1709 providers in-state (98th percentile; notably above typical state volume for this code). This indicates routine capture of common ED ancillary billing in addition to core E/M encounters rather than reliance solely on high-acuity procedure codes.
The provider has an NPI enumerated on 2006-05-25 (~20 years ago), indicating long tenure in the market; combined with the concentrated, high-volume Medicaid ED billing and top statewide ranks, this suggests an established emergency medicine operation with sustained Medicaid-facing volume over many years.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
10 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. | 145,250 | $70 | $10.5M |
| 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. | 113,720 | $90 | $10.3M |
| 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. | 120,840 | $40 | $5.3M |
| 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… | 1,790 | $140 | $245.2K |
| 99053 | The provider renders overnight services at a 24 hour facility. | 26,950 | $1 | $107.8K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 11,500 | $1 | $46K |
| 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. | 310 | $30 | $8.8K |
| 99281 | The provider sees a patient for the lowest level emergency department visit. | 40 | $20 | $650 |
| 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 | $200 |
| 99406 | The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes. | 20 | $10 | $170 |
How this provider's Medicaid billing volume and revenue compare to other Illinois providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Illinois median
10 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 | 2,480 | 760 | $90 | $102K |
| 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 | 2,920 | 770 | $60 | $75.8K |
| 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… | 47 | 1,000 | 100 | $110 | $47.3K |
| 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 | 2,840 | 500 | $40 | $37.3K |
| 99281 | The provider sees a patient for the lowest level emergency department visit. | 27 | 90 | 20 | $60 | $18.4K |
| 93010 | The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram. | 39 | 1,710 | 750 | $10 | $18.2K |
| 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… | 1,051 | 1,150 | 1,520 | $1 | $10.5K |
| 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. | 204 | 880 | 100 | $30 | $9.1K |
| 99406 | The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes. | 97 | 120 | 80 | $1 | $2.1K |
| 99053 | The provider renders overnight services at a 24 hour facility. | 1 | 130 | 100 | $1 | $820 |
Other providers in the same ZIP code as Southeastern Emergency Physicians Of Memphis LLC, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Centerstone Of Illinois, Inc | IL | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $36.7M |
| Southern Illinois Health Care Foundation, Inc. | IL | Federally Qualified Health Center (FQHC) | $0 | $21.1M |
| Nu-crown, LLC | IL | Optometrist | $0 | $5.8M |
| Alton Memorial Hospital | IL | Ambulance | $0 | $4.1M |
| City Of Alton Ill | IL | Ambulance | $254.8K | $3.4M |
| Osf Healthcare System | IL | Home Health Agency | $0 | $3.4M |
| Centerstone Of Illinois, Inc | IL | Substance Use Disorder Rehabilitation Clinic/Center | $133.7K | $1.9M |
| Wynndel Buenger | IL | Pain Medicine Physician | $399.4K | $4.5K |
| Paolo Masetti | IL | Surgical Critical Care Physician | $94.1K | $182.7K |
| John Stirton | IL | Orthopaedic Surgery Physician | $202.4K | $20.2K |
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