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

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

Qualified Emergency Specialists Inc (NPI 1700872728)

Field	Value
Entity Type	Organization
Organization	Qualified Emergency Specialists Inc
Address	10500 Montgomery Rd
City	Cincinnati
State	OH
ZIP	45242
Taxonomy	Emergency Medicine Physician
NPI Enumerated	September 26, 2005

Payer Source	Total Paid
Medicaid	$18.9M
Medicare	$0

Medicaid: Complete Services Breakdown

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

9 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.	140,130	$70	$9.5M
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.	143,960	$50	$7.1M
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.	71,760	$30	$2.2M
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…	3,680	$40	$161.9K
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.	330	$20	$5.5K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	230	$10	$1.1K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	10	$50	$740
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	270	$0	$0
G9744	Patient not eligible due to active diagnosis of hypertension	30	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Ohio Distribution

Qualified Emergency Specialists Inc — 2 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Ohio

Full comparison — all codes billed, vs. Ohio median

9 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.	35	480	4,510	$90	$1.8M
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.	17	660	460	$90	$1.5M
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.	10	580	510	$100	$1.3M
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.	165	230	2,200	$100	$530.1K
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…	35	260	280	$50	$120.1K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	13	10	60	$130	$17.8K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	195	400	200	$10	$15.6K
G8427	Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications	364	630	500	$1	$20
G9744	Patient not eligible due to active diagnosis of hypertension	56	70	270	$1	$10

Related Providers

Other providers that share a Tax Identification Number (TIN) with Qualified Emergency Specialists Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
David Sower	KY	Sports Medicine (Emergency Medicine) Physician	$115.6K	$0
Gary Gries	OH	Emergency Medicine Physician	$86.1K	$0
Brian Braxton	OH	Emergency Medicine Physician	$67.1K	$0
Don Duke	OH	Emergency Medicine Physician	$53.6K	$0
John Stadnik	OH	Emergency Medicine Physician	$37.7K	$0
Clinton Wheeler	OH	Surgical Physician Assistant	$5.2K	$0

Nearby Providers

Other providers in the same ZIP code as Qualified Emergency Specialists Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Maxim Healthcare Services, Inc.	OH	Home Health Agency	$0	$63.6M
Bethesda Hospital Inc	OH	General Acute Care Hospital	$0	$57M
Hospice Of Cincinnati Incorporated	OH	Community Based Hospice Care Agency	$0	$54M
Carestar, Inc.	OH	Case Management Agency	$0	$43.1M
Counseling Source Inc	OH	Mental Health Counselor	$0	$41M
Mercy Health Physicians Cincinnati, LLC	OH	Family Medicine Physician	$0	$27.9M
Crossroads Hospice Of Cincinnati	OH	Community Based Hospice Care Agency	$0	$14.6M
A Best Home Care,inc.	OH	Home Health Agency	$0	$10.4M
Cei Physicians Psc LLC	OH	Ophthalmology Physician	$0	$8.5M
Mercy Health Physicians Cincinnati Specialty Care LLC	OH	Surgery Physician	$0	$7.1M

Qualified Emergency Specialists Inc — Billing Profile & Reimbursement Data

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Qualified Emergency Specialists 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

Related Providers

Nearby Providers

Frequently Asked Questions

References