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NPI 1699974675 · Apo, AP · Emergency Medicine Physician
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Adam Ash is a emergency medicine physician provider located in Apo, Armed Forces Pacific. This profile covers 7 Medicare and 5 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services. Note: "AP" is a US military postal designation for Armed Forces stationed in the Asia-Pacific region — not a traditional US state; claims coded under it are grouped and benchmarked here the same way a traditional state would be.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Adam Ash |
| Address | Unit 15244 |
| City | Apo |
| State | AP (Armed Forces Pacific) |
| ZIP | 96205 |
| Taxonomy | Emergency Medicine Physician |
| NPI Enumerated | July 11, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $104.2K |
| Medicaid | $23.7K |
Payer mix and scale: This clinician reports $104.2K in total Medicare revenue and $23.7K in total Medicaid revenue, so Medicare represents the larger revenue stream for this NPI while Medicaid is a meaningful but smaller contributor. The presence of substantial billing to both programs indicates a mixed payer profile rather than single-payer dependence.
Medicare revenue concentration: The provider's Medicare revenue is highly concentrated in emergency and critical care codes — the precomputed top-three Medicare codes account for 87.9% of Medicare revenue, driven by 99285 (50.5% of Medicare revenue), 99284 (24.1%), and 99291 (13.3%). This concentration signals an ED/acute care service-line where a small set of high-acuity E/M and critical care codes dominate billings.
Medicaid revenue concentration: Medicaid revenue is even more concentrated in ED visit codes — the precomputed top-three Medicaid codes account for 100.0% of Medicaid revenue, dominated by 99285 (77.4% of Medicaid revenue), 99284 (16.8%), and 99283 (5.8%). Medicaid billing is therefore almost entirely emergency-department E/M activity for this provider.
Service-line implications from code mix: The taxonomy and code mix (heavy use of 99285, 99284, and presence of 99291 and inpatient E/M codes such as 99223 and 99222 on Medicare) are consistent with practice as an emergency medicine physician who handles high-acuity ED visits and performs some critical care and inpatient evaluation/management. The mix suggests hospital-based ED staffing with capacity for complex, high-decision-making encounters rather than primarily low-acuity outpatient work.
Competitive standing — Medicare: For specific Medicare codes the provider shows mixed national competitiveness: 99284 is in the 97th percentile nationally and is labeled “notably above typical” national volume, indicating unusually high moderate-complexity ED volume relative to peers; 99285 is in the 91th percentile but described as “typical, unremarkable volume,” and 99291 is at the 66th percentile described as typical. In aggregate this indicates above-average activity on select ED codes but not universal dominance across all acute-care CPTs.
Competitive standing — Medicaid/state-level: On Medicaid the provider ranks #1 of 4 in-state for 99285 (100th percentile, labeled “typical, unremarkable volume”), making them a leading state biller for high-complexity ED visits within a small peer set; 99284 and 99283 are mid-to-lower in-state (50th and 33th percentiles respectively). The small number of in-state peers (e.g., 4–5 providers) makes these rank comparisons sensitive to peer composition, so leadership claims should be interpreted in that context.
Payment and utilization patterns: The same high-acuity ED code shows very different payment dynamics across payers: 99285 has an avg paid/claim of $169 on Medicare (312 claims, $52.7K revenue) versus $29 avg paid/claim on Medicaid (640 claims, $18.6K revenue), indicating higher per-claim Medicare reimbursement alongside higher Medicaid claim volume for that code. These stated per-claim and claim-count figures suggest the provider delivers many Medicaid ED encounters at much lower per-claim reimbursement, which materially shapes total revenue by payer.
Documentation/quality-code activity: The provider has reported non-revenue quality/documentation codes on Medicaid — G9744 (26 claims, $0 revenue) and G8428 (93 claims, $0 revenue) — indicating capture of quality or exclusion documentation without associated payment. Such $0-paid claims are common for measure reporting and should be considered part of administrative/quality workflows rather than a revenue source.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
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. | 310 | $170 | $52.7K |
| 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. | 220 | $120 | $25.2K |
| 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… | 70 | $210 | $13.9K |
| 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… | 40 | $160 | $5.7K |
| 99238 | The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the… | 40 | $70 | $2.8K |
| 99222 | The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or… | 20 | $120 | $2.2K |
| 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. | 30 | $70 | $1.9K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes. Note: this provider's state, "AP," is a US military postal designation for Armed Forces stationed in the Asia-Pacific region — not a traditional US state; the State panel below benchmarks against other providers coded under the same designation.
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.
5 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. | 640 | $30 | $18.6K |
| 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. | 170 | $20 | $4K |
| 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. | 100 | $10 | $1.4K |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 90 | $0 | $0 |
| G9744 | Patient not eligible due to active diagnosis of hypertension | 30 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Armed Forces Pacific providers billing the same CPT/HCPCS codes. Note: "AP" is a US military postal designation for Armed Forces stationed in the Asia-Pacific region — not a traditional US state; claims coded under it are benchmarked here as their own state-equivalent group.
Full comparison — all codes billed, vs. Armed Forces Pacific median
5 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 | 10 | 530 | $50 | $23.8K |
| 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 | 10 | 170 | $50 | $11.8K |
| 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. | 3 | 10 | 130 | $30 | $4.5K |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 1 | 10 | 90 | $0 | $0 |
| G9744 | Patient not eligible due to active diagnosis of hypertension | 1 | 10 | 30 | $0 | $0 |
Other providers in the same ZIP code as Adam Ash, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Britton Birtcher | AP (Armed Forces Pacific) | Dentist | $0 | $285.8K |
| Jiyoon Kim | AP (Armed Forces Pacific) | Diagnostic Radiology Physician | $191.9K | $0 |
| Jeremy Rich | AP (Armed Forces Pacific) | Otolaryngology Physician | $44K | $0 |
| Daniel Martens | — | Physician Assistant | $18.8K | $0 |
| Christopher Metcalf | AP (Armed Forces Pacific) | Physician Assistant | $17.6K | $0 |
| Harry Aubin | AP (Armed Forces Pacific) | Surgery Physician | $13K | $0 |
| Beatriz Meza-valencia | AP (Armed Forces Pacific) | Pediatrics Physician | $0 | $3K |
| Yanghoe Koo | AP (Armed Forces Pacific) | General Practice Dentistry | $0 | $470 |
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