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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

Brown Emergency Medicine (NPI 1962455022)

Field	Value
Entity Type	Organization
Organization	Brown Emergency Medicine
Address	593 Eddy St
City	Providence
State	RI
ZIP	02903
Taxonomy	Emergency Medicine Physician
NPI Enumerated	May 18, 2006

Payer Source	Total Paid
Medicaid	$12.3M
Medicare	$0

Key Findings

This provider is effectively single‑payer in scope: there is no Medicare billing on file while total Medicaid revenue is $12.3M. The absence of Medicare activity means analyses of fee schedule differences, dual‑eligibility mix, and Medicare-centric risk profiles are not applicable; Medicaid is the revenue driver for all observed activity.

Revenue is highly concentrated in a narrow set of emergency department E/M codes: the top three Medicaid codes (99284, 99285, 99283) account for 90.4% of the provider's Medicaid revenue. Individually those codes represent $4.4M (35.5%), $3.9M (31.9%), and $2.8M (22.9%) of Medicaid revenue respectively, showing the business depends on moderate‑to‑high complexity ED visits for the vast majority of its receipts.

Operational scale on ED visits is unusually large: 99284 has 70.7K claims, 99283 has 64.4K claims, and 99285 has 45.8K claims, with average paid/claim of $62, $44, and $86 respectively for those codes. Those claim volumes, paired with the dollar per claim levels, indicate a very high throughput emergency practice model focused on episodic ED care rather than longitudinal outpatient management.

Competitive standing in‑state is dominant for core ED codes: the provider ranks #1 in Rhode Island for 99284 (1 of 339, 100th percentile; extreme outlier), 99285 (1 of 277, 100th percentile; extreme outlier), and 99283 (1 of 291, 100th percentile; extreme outlier). These percentile and rank positions characterize the provider as a major statewide outlier in volume for emergency department services, far above typical state peer volume for these codes.

The code mix supports a procedurally capable emergency practice beyond E/M visits: the file shows meaningful use of critical care (99291 — 6.5K claims, $460.4K revenue, 3.7%), procedural sedation (99156/99157), airway management (31500), and wound repairs (12011, 12001). Together these codes indicate the provider manages higher‑acuity presentations and performs common ED procedures onsite rather than referring them, contributing to both revenue and clinical scope.

A few secondary codes further underline capability and scale in acute care: 99220 and 99217 appear with notable state ranks (each #1 of small peer sets) and there are single‑provider state volumes for several procedure codes (e.g., 99236, 12002, 99157) that suggest this group or practice handles a range of ED and observation/hospital encounters in the market. These patterns point to an integrated emergency operations model that captures both ED throughput and some observation/inpatient transition care.

The provider has long tenure in the NPI registry (enumerated 2006-05-18 (~20 years ago)), indicating an established presence in the market; that longevity combined with the outsized ED volumes suggests market incumbency rather than a recent entrant scaling quickly. Tenure should be considered when benchmarking utilization and negotiating network participation or service agreements.

From a utilization management and contracting perspective, the extreme concentration (90.4% of Medicaid revenue from three ED codes) and multiple "extreme outlier" rank labels warrant focused review for capacity planning and payer contracting. Because there is no Medicare volume to balance payer exposure, Medicaid policy changes or rate negotiations could materially affect the provider's revenue stream, and payers should prioritize ED utilization patterns, critical care claims (including 99291), and procedural mix in any oversight or contracting discussions.

Medicaid: Complete Services Breakdown

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

26 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.	70,660	$60	$4.4M
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.	45,800	$90	$3.9M
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.	64,370	$40	$2.8M
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…	6,490	$70	$460.4K
99220	N/A	2,530	$130	$321.1K
99217	N/A	3,140	$60	$188.5K
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.	2,070	$20	$47.7K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	910	$50	$43.8K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	870	$40	$37.5K
99219	N/A	270	$80	$22.5K

Showing 1–10 of 26

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

Brown Emergency Medicine — 9 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

26 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	280	290	$260	$296.3K
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	340	370	$200	$272.8K
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.	1	290	180	$170	$224.1K
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.	6	70	170	$170	$124.4K
99219	N/A	1	10	170	$600	$100.2K
99220	N/A	1	10	30	$150	$83.2K
99281	The provider sees a patient for the lowest level emergency department visit.	9	10	90	$170	$58.4K
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…	1	30	170	$110	$51.4K
99217	N/A	1	10	80	$60	$38K
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…	28	40	40	$70	$28.3K

Showing 1–10 of 26

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lawrence Proano	RI	Emergency Medicine Physician	$48.4K	$2.3M
Dina Gozman	RI	Emergency Medicine Physician	$59.9K	$1.2M
Otis Warren	RI	Emergency Medicine Physician	$39K	$942.1K
James Giddings	RI	Emergency Medicine Physician	$78.4K	$889.8K
Charles Stengel	RI	Emergency Medicine Physician	$59K	$870.4K
Frantz Gibbs	RI	Emergency Medicine Physician	$31.4K	$849.2K
James Monti	RI	Emergency Medicine Physician	$28.1K	$825.3K
Robert Tubbs	RI	Emergency Medicine Physician	$44K	$709.6K
Alexis Kearney	RI	Emergency Medicine Physician	$41.8K	$559.3K
Achyut Kamat	RI	Emergency Medicine Physician	$42.6K	$553.5K

Nearby Providers

Other providers in the same ZIP code as Brown Emergency Medicine, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rhode Island Hospital	RI	General Acute Care Hospital	$0	$380.8M
Maxim Healthcare Services, Inc.	RI	Home Health Agency	$0	$32.1M
Children's Friend And Service	RI	Voluntary or Charitable Agency	$0	$18.7M
City Of Providence Rhode Island	RI	Local Education Agency (LEA)	$0	$18.6M
The Providence Center	RI	Emotionally Disturbed Childrens' Residential Treatment Facility	$0	$11.9M
Brown Neurology	RI	Neurology Physician	$0	$9.9M
One Stone L.L.C.	RI	Home Health Agency	$0	$8.6M
Recovery Connection Centers Of America, Inc.	RI	Multi-Specialty Clinic/Center	$0	$7.5M
City Of Providence Rhode Island	RI	Land Ambulance	$917.7K	$6.4M
Lifespan Physician Group, Inc.	RI	General Practice Physician	$0	$5.6M

Brown Emergency Medicine — Billing Profile & Reimbursement Data

Sign up for Brown Emergency Medicine — Billing Profile & Reimbursement Data policy alerts

Brown Emergency Medicine — Billing Profile & Reimbursement Data

Sign up for Brown Emergency Medicine — Billing Profile & Reimbursement Data policy alerts

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