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

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

Paragon Emergency Services LLC (NPI 1912101650)

Field	Value
Entity Type	Organization
Organization	Paragon Emergency Services LLC
Address	200 Avenue F Ne
City	Winter Haven
State	FL
ZIP	33881
Taxonomy	Emergency Medicine Physician
NPI Enumerated	June 14, 2007

Payer Source	Total Paid
Medicaid	$53.1M
Medicare	$0

Key Findings

PARAGON EMERGENCY SERVICES LLC reports $53.1M in lifetime Medicaid revenue and has no Medicare billing on file, making its publicly observed payer footprint effectively single-payer (Medicaid) in scale. This concentration on Medicaid should be treated as the principal revenue stream for any competitive or utilization analysis of the entity.

Revenue is highly concentrated in three emergency department E/M codes: 99284 ($21.8M, 351.3K claims, $62 avg paid/claim; 41.0% of total Medicaid revenue), 99285 ($17.6M, 250.9K claims, $70 avg paid/claim; 33.1% of total Medicaid revenue), and 99283 ($13.4M, 298.3K claims, $45 avg paid/claim; 25.3% of total Medicaid revenue). Those three codes together account for 99.4% of this provider’s reported Medicaid revenue, indicating extreme revenue concentration in ED E/M visits.

The provider’s taxonomy as Emergency Medicine Physician combined with the dominant code mix (99284, 99285, 99283) indicates an operation focused on high-volume emergency department evaluation-and-management services, with a mix of low-, moderate- and high-level decision-making visits driving nearly all Medicaid revenue. The large claim counts for these E/M codes are consistent with a high-throughput ED setting rather than subspecialty outpatient practice.

Competitive standing within Florida is dominant for core ED E/M activity: 99284 ranks #4 of 739 providers in-state (100th percentile; extreme outlier), 99285 ranks #3 of 658 providers (100th percentile; extreme outlier), and 99283 ranks #2 of 701 providers (100th percentile; extreme outlier). These rank/percentile positions mark PARAGON as a major statewide volume leader for emergency department visits billed to Medicaid.

While ED E/M codes dominate, critical care services (99291) represent only $228.1K (0.4% of Medicaid revenue) with 2.8K claims and an average paid/claim of $81; that code ranks #41 of 404 providers in-state (90th percentile; typical, unremarkable volume). This suggests a relatively small footprint of billed critical care time relative to the provider’s overall ED workload.

Ancillary and support codes show mixed signals: 93010 (ECG interpretation) appears at 46.2K claims for $46.2K revenue (0.1% of Medicaid revenue) and ranks #17 of 636 providers in-state (97th percentile; notably above typical state volume), while 99053 (overnight services) shows 56K claims but $0 revenue (0.0%) and ranks #2 of 35 providers in-state (97th percentile; notably above typical). These patterns point to substantial operational activity (e.g., 24-hour facility coverage and frequent ECGs) that produces little direct Medicaid revenue for some ancillary codes.

The claim-level economics show high throughput with relatively modest average payments per claim on the big-volume E/M codes (99284 $62 avg paid/claim, 99285 $70 avg paid/claim, 99283 $45 avg paid/claim). Combined with the large claim volumes, this pattern indicates a business model dependent on scale of visits rather than high per-claim reimbursement.

PARAGON’s NPI was enumerated on 2007-06-14 (~19 years ago), indicating an established presence in the market; when paired with its top-state ranks on core ED codes, the tenure supports the interpretation of a longstanding, high-volume emergency services operation in Winter Haven, FL. Analysts evaluating network capacity or Medicaid utilization should treat this provider as a long-standing, high-capacity ED-focused entity in-state.

Medicaid: Complete Services Breakdown

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

8 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.	351,270	$60	$21.8M
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.	250,850	$70	$17.6M
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.	298,290	$50	$13.4M
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…	2,820	$80	$228.1K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	46,170	$1	$46.2K
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.	1,300	$30	$40.3K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	2,560	$1	$2.6K
99053	The provider renders overnight services at a 24 hour facility.	55,980	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Florida Distribution

Paragon Emergency Services LLC — 5 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Florida

Full comparison — all codes billed, vs. Florida median

8 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.	2	700	2,400	$80	$1.2M
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.	4	740	2,180	$70	$1.1M
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	660	1,900	$70	$743.6K
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.	180	320	1,970	$90	$463.1K
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…	41	400	190	$80	$118.2K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	17	640	640	$1	$22.5K
99053	The provider renders overnight services at a 24 hour facility.	2	40	100	$1	$1.6K
99406	The provider counsels the patient on how to stop tobacco use. The counseling lasts more than three minutes, up to 10 minutes.	9	200	70	$1	$1.5K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jose Avila	FL	Emergency Medicine Physician	$770.7K	$0
Edward Lucas	FL	Emergency Medicine Physician	$165K	$257.3K
Ruslan Ivanov	FL	Emergency Medicine Physician	$267.9K	$0
Donal Spry	MI	Emergency Medicine Physician	$232.8K	$0
Marisa Burkey	FL	Emergency Medicine Physician	$166K	$0
Julie Alexander	FL	Internal Medicine Physician	$164.9K	$0
Jose Lopez-estrada	FL	Emergency Medicine Physician	$162.2K	$0
Dae Yang	MN	Emergency Medicine Physician	$158.3K	$0
Movva Reddy	NC	Emergency Medicine Physician	$152.9K	$0
Indra Arya	ND	Emergency Medicine Physician	$119.1K	$0

Nearby Providers

Other providers in the same ZIP code as Paragon Emergency Services LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Winter Haven Hospital Inc	FL	General Acute Care Hospital	$0	$26.3M
Rai Care Centers Of Florida Ii, LLC	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$11.2M
Dva Healthcare Renal Care Inc	FL	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$10.7M
Senior Health-winter Haven, LLC	FL	Skilled Nursing Facility	$0	$10.6M
Maurice Mccarthy	FL	Rheumatology Physician	$1.3M	$0
Winter Haven Ambulatory Surgical Center LLC	FL	Ambulatory Surgical Clinic/Center	$958.9K	$121.4K
Zaheed Tai	FL	Cardiovascular Disease Physician	$814.7K	$0
Ahmad El-far	FL	Hematology & Oncology Physician	$814.5K	$0
Richard Lacalamito	FL	Family Medicine Physician	$391K	$0
Jose Martinez-salas	FL	Pulmonary Disease Physician	$367.1K	$0

Paragon Emergency Services LLC — Billing Profile & Reimbursement Data

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Paragon Emergency Services LLC — 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