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

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

Emergency Services Of Montgomery PC (NPI 1528310323)

Field	Value
Entity Type	Organization
Organization	Emergency Services Of Montgomery PC
Address	124 S Memorial Dr
City	Prattville
State	AL
ZIP	36067
Taxonomy	Emergency Medicine Physician
NPI Enumerated	October 4, 2012

Payer Source	Total Paid
Medicaid	$13.7M
Medicare	$0

Key Findings

This practice has no Medicare billing on file and reports $13.7M in lifetime Medicaid revenue, making it effectively a single-payer (Medicaid) billing operation at present. The provider’s NPI was enumerated 2012-10-04 (~14 years ago), indicating an established presence in the market during that period.

Revenue is highly concentrated in three emergency department E/M codes: 99285 accounts for $6.1M (44.5% of Medicaid revenue), 99284 accounts for $5.7M (42.0%), and 99283 accounts for $1.7M (12.3%); the top 3 codes together drive 98.8% of this provider’s total Medicaid revenue. This concentration suggests most financial performance depends on high-volume ED evaluation and management services.

The code mix (99285, 99284, 99283) indicates the organization operates primarily as an emergency services provider focused on ED evaluation and management across high, moderate, and low complexity visits. High claim volumes—85.8K claims for 99285, 117.3K claims for 99284, and 54.4K claims for 99283—combined with average paid/claim levels ($71, $49, and $31 respectively) point to a business model driven by throughput of ED visits rather than high per-claim reimbursements.

Competitive standing in-state is pronounced for core ED codes: 99284 ranks #2 of 238 providers in-state (100th percentile, extreme outlier) and 99285 ranks #3 of 193 (99th percentile), while 99283 ranks #7 of 230 (97th percentile). These rank/percentile positions identify the provider as a major volume leader for ED E/M services within Alabama, particularly for the moderate- and high-complexity visit codes.

Operational detail supports 24-hour emergency coverage: code 99053 shows 58.4K claims and $0 revenue and ranks #1 of 19 providers in-state (100th percentile; notably above typical state volume for this code), consistent with frequent overnight service reporting at a 24-hour facility. While the $0 paid/claim figure yields no direct revenue, the high claim count signals consistent overnight operational activity that aligns with the ED-focused billing mix.

Ancillary ED services are also billed at scale: 93010 appears on 27.8K claims for $138.9K revenue (1.0% of Medicaid revenue) and ranks #6 of 173 providers in-state (97th percentile; notably above typical state volume for this code). This pattern—frequent ECG interpretation with modest per-claim payment ($5 avg paid/claim)—is consistent with routine cardiac workups embedded in high ED visit volumes.

Critical care and very low-complexity ED codes are a minor part of revenue and volume: 99291 shows 282 claims for $25.7K (0.2% of revenue) and ranks #28 of 59 providers in-state (53th percentile; typical, unremarkable volume), while 99282 has only 15 claims and $165 revenue and ranks #121 of 134 (9th percentile; typical, unremarkable volume). These results suggest the provider’s activity concentrates on standard ED evaluations rather than prolonged critical-care billing or an outsized share of straightforward encounters.

From a payer and contracting lens, the combination of a single major payer (Medicaid), extreme state-level volume concentration in three ED E/M codes, and long tenure (~14 years since enumeration) signals both market strength in emergency services and operational risk exposure to any Medicaid rate or policy changes that affect 99285/99284/99283 reimbursement. The provider’s dominant ranks for core ED codes make it a key Medicaid ED billing entity in-state, but its heavy revenue dependence on a few codes concentrates payer and policy sensitivity.

Medicaid: Complete Services Breakdown

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

7 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.	85,790	$70	$6.1M
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.	117,250	$50	$5.7M
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.	54,430	$30	$1.7M
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	27,790	$10	$138.9K
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…	280	$90	$25.7K
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.	20	$10	$170
99053	The provider renders overnight services at a 24 hour facility.	58,370	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

Emergency Services Of Montgomery PC — 4 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

7 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.	2	240	4,820	$60	$807.6K
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.	3	190	1,480	$100	$730.7K
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.	7	230	5,160	$40	$474.1K
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.	121	130	420	$40	$106K
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…	28	60	270	$110	$94.3K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	6	170	890	$10	$25.2K
99053	The provider renders overnight services at a 24 hour facility.	1	20	1,060	$1	$80

Related Providers

Other providers that share a Tax Identification Number (TIN) with Emergency Services Of Montgomery PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Andres Borrero Mendoza	PR	Emergency Medicine Physician	$49.2K	$0
Laura Walls	AL	Family Nurse Practitioner	$39.7K	$0
Gabriella Soler-banchs	PR	Emergency Medicine Physician	$23.1K	$0

Nearby Providers

Other providers in the same ZIP code as Emergency Services Of Montgomery PC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
The Health Care Authority For Baptist Health An Affiliate Of Uabhs	AL	General Acute Care Hospital	$0	$5.2M
The Bailey Center, LLC	AL	Speech-Language Pathologist	$0	$3.2M
Little Peach Feeding And Speech, LLC	AL	Speech-Language Pathologist	$0	$1.3M
City Of Prattville	AL	Land Ambulance	$257.6K	$259.8K

Emergency Services Of Montgomery PC — Billing Profile & Reimbursement Data

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Emergency Services Of Montgomery PC — 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