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

Why is the Medicaid comparison limited to New Jersey 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. New Jersey (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.

St. Joseph's Emergency Physicians Inc (NPI 1568791192)

St. Joseph's Emergency Physicians Inc is a emergency medical services (emergency medicine) physician provider located in Paterson, New Jersey. This profile covers 0 Medicare and 14 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	St. Joseph's Emergency Physicians Inc
Address	703 Main St
City	Paterson
State	NJ
ZIP	07503
Taxonomy	Emergency Medical Services (Emergency Medicine) Physician
NPI Enumerated	December 10, 2009

Payer Source	Total Paid
Medicaid	$24.2M
Medicare	$0

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

14 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.	181,990	$90	$15.7M
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.	43,200	$100	$4.4M
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.	55,600	$50	$2.9M
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…	4,850	$140	$698.8K
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.	15,900	$30	$508.9K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	2,320	$10	$25.5K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	290	$40	$11.2K
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…	3,340	$1	$10K
36569	The provider places a catheter through a vein in the upper extremity of a patient 5 years of age or older and passes the catheter into one of the major veins carrying the blood to the heart or…	20	$70	$980
76937	The provider uses ultrasound to help guide procedures requiring vascular access including central venous, peripheral venous, or arterial access procedures.	30	$10	$230

Showing 1–10 of 14

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. New Jersey Distribution

St. Joseph's Emergency Physicians Inc — 1 of 11 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — New Jersey

Full comparison — all codes billed, vs. New Jersey median

14 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.	31	260	4,240	$220	$4.1M
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.	3	320	580	$230	$4M
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.	23	280	920	$200	$2.6M
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	140	1,410	$180	$1.3M
99281	The provider sees a patient for the lowest level emergency department visit.	86	90	750	$130	$281.3K
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…	14	230	210	$160	$189K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	31	90	110	$30	$26.4K
36569	The provider places a catheter through a vein in the upper extremity of a patient 5 years of age or older and passes the catheter into one of the major veins carrying the blood to the heart or…	7	10	40	$150	$12.8K
76937	The provider uses ultrasound to help guide procedures requiring vascular access including central venous, peripheral venous, or arterial access procedures.	41	60	80	$20	$7.9K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	10	170	80	$10	$2.9K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Avinash Ravilla	NY	General Practice Physician	$1.3M	$0
Ryan Murphy	CT	Emergency Medicine Physician	$125.4K	$0
Aaditya Desai	NJ	Emergency Medicine Physician	$37.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St Josephs University Medical Center Inc.	NJ	General Acute Care Hospital	$0	$322.3M
St. Joseph's Healthcare, Inc.	NJ	Internal Medicine Physician	$0	$31.7M
Fayrouz Pediatric LLC	NJ	Pediatrics Physician	$0	$13.3M
St. Josephs Hospital And Medical Center	NJ	Mental Illness Community Based Residential Treatment Facility	$0	$13.2M
Simeon Dialysis LLC	NJ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$12.9M
St Josephs Medical Group PC	NJ	Internal Medicine Physician	$0	$10.1M
Imaging Subspecialists Of North Jersey, LLC	NJ	Diagnostic Radiology Physician	$0	$7.5M
Ellsworth Wright	NJ	Emergency Medicine Physician	$247.3K	$0
Orestes Sanchez	NJ	Diagnostic Radiology Physician	$225.5K	$0
Edward Milman	NJ	Diagnostic Radiology Physician	$221.9K	$0

St. Joseph's Emergency Physicians Inc — Billing Profile & Reimbursement Data

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St. Joseph's Emergency Physicians Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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