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.

Rwjbh Emergency Medicine Associates, LLC (NPI 1912510041)

Key Findings

Field	Value
Entity Type	Organization
Organization	Rwjbh Emergency Medicine Associates, LLC
Address	3 Executive Dr
City	Somerset
State	NJ
ZIP	08873
Taxonomy	Emergency Medicine Physician
NPI Enumerated	August 28, 2020

Payer Source	Total Paid
Medicaid	$117.8M
Medicare	$0

This entity is effectively single‑payer in the available data: Medicare billing is listed as none while Medicaid revenue totals $117.8M, indicating the provider’s recorded scope of activity is concentrated entirely in Medicaid. The NPI was enumerated on 2020-08-28 (~6 years ago), so the organization has been active under this identifier for roughly six years.

Revenue is highly concentrated in a small set of ED E/M codes: 99284, 99285, and 99283 together account for 87.4% of the provider’s total Medicaid revenue. Individually those codes produced $52.1M (44.2%), $43.6M (37.0%), and $7.3M (6.2%) respectively, which shows the business is overwhelmingly dependent on emergency department evaluation-and-management services.

The code mix identifies the operation as an emergency medicine practice with substantial inpatient/observation involvement. High-volume ED E/M codes (99284 and 99285) dominate revenue, while inpatient and observation codes such as 99233 ($5.6M, 4.8%) and 99236 ($1.7M, 1.4%) indicate the group also provides significant subsequent inpatient/observation care and same-day admit/discharge management.

Competitive standing within New Jersey is dominant for core ED services: the provider ranks #1 in-state for 99284 (of 319 providers) and for 99285 (of 282 providers), both at the 100th percentile and labeled an "extreme outlier," meaning its volume for those codes is far above typical state peers. This suggests market leadership in Medicaid-covered emergency care rather than a modest participant.

Several supporting codes further underscore a large, high-acuity caseload: 99233 (81.4K claims, $5.6M) ranks #3 of 662 providers at the 100th percentile (extreme outlier), and 99232 (58.6K claims, $1.5M) ranks in the 99th percentile. These placements indicate sustained high volumes not just in front‑end ED visits but throughout inpatient/observation follow-up encounters.

The provider also reports notable usage of high‑intensity and advanced‑planning services: critical care 99291 generated $1.7M (1.5%) and ranks #7 of 226 providers at the 97th percentile (notably above typical state volume), while 99497 (advance care planning) ranks #2 of 175 providers at the 99th percentile (extreme outlier). Those patterns are consistent with managing critically ill patients and engaging in formal advance‑care discussions at scale.

Ancillary diagnostic throughput appears elevated for certain routine tests tied to emergency practice: 93042 shows 13.8K claims and $27.7K revenue, ranking #2 of 30 providers at the 97th percentile (extreme outlier). That volume aligns with high ED visit counts and suggests consistent use of basic cardiac monitoring services across the case mix.

The provider’s extreme reliance on a narrow set of ED E/M codes (the top three contribute 87.4% of Medicaid revenue) creates concentrated operational and reimbursement exposure: shifts in Medicaid policy, payment rates, or coding practice for 99284/99285/99283 could materially affect overall revenue. From a payer or competitive-analytics perspective, this profile identifies the practice as a high-volume, Medicaid-focused emergency medicine group with state-level dominance for core ED services.

Medicaid: Complete Services Breakdown

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

41 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.	354,620	$150	$52.1M
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.	284,670	$150	$43.6M
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.	129,860	$60	$7.3M
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	81,430	$70	$5.6M
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…	19,360	$140	$2.6M
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…	8,350	$210	$1.7M
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	5,390	$310	$1.7M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	58,580	$30	$1.5M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	8,430	$90	$775.5K
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…	2,840	$110	$324.1K

Showing 1–10 of 41

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

Rwjbh Emergency Medicine Associates, LLC — 12 of 25 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

41 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.	5	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.	1	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.	1	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.	75	140	1,410	$180	$1.3M
99281	The provider sees a patient for the lowest level emergency department visit.	80	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…	7	230	210	$160	$189K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	2	30	120	$210	$168.8K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	12	1,020	550	$30	$105.3K
76705	An abdominal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e. liver, gallbladder, pancreas, bile ducts, spleen, and abdominal aorta). This particular code…	90	140	810	$50	$93K
76815	The provider performs a limited examination of the fetus using ultrasound. The provider performs the examination of certain parameters for one or more fetuses.	79	130	440	$50	$88.3K

Showing 1–10 of 41

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Hackensack Meridian Health Medical Group - Primary Care PC	NJ	Family Medicine Physician	$0	$21.9M
Jasminka Balderacchi	NY	Anatomic Pathology & Clinical Pathology Physician	$1.9M	$0
Varun Bhatia	NJ	Family Medicine Physician	$504.5K	$0
James Orsini	NJ	Hematology & Oncology Physician	$413.3K	$0
Rajagopalan Rengan	PA	Pulmonary Disease Physician	$360.8K	$0
Brenden Brunner	NJ	Internal Medicine Physician	$351.2K	$0
Shilpan Shah	NJ	Internal Medicine Physician	$323K	$0
Ellsworth Wright	NJ	Emergency Medicine Physician	$247.3K	$0
Frank Reda	NJ	Internal Medicine Physician	$234.7K	$0
Samuel Carino	NJ	Emergency Medicine Physician	$211K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rem New Jersey, Inc.	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$218M
Everas Community Services, Inc.	NJ	Developmentally Disabled Services Day Training Agency	$0	$114.2M
Premier Supports, LLC	NJ	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$71.4M
Forever Young Medical Day Care	NJ	Adult Day Care Clinic/Center	$0	$35.8M
Audiology Services Company Usa, LLC	NJ	Hearing and Speech Clinic/Center	$0	$33.3M
Paradise Adult Day Healthcare LLC	NJ	Adult Day Care Clinic/Center	$0	$27M
National Mentor Healthcare, LLC	NJ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$10.7M
Franklin Township Publc Schools	NJ	Local Education Agency (LEA)	$0	$9.3M
Jersey Behavioral Care LLC	NJ	Mental Health Counselor	$0	$8.7M
Rainbow Healthcare Inc.	NJ	Adult Day Care Clinic/Center	$0	$7.3M

Rwjbh Emergency Medicine Associates, LLC — Billing Profile & Reimbursement Data

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Rwjbh Emergency Medicine Associates, 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