Is NORTHWEST EMERGENCY PHYSICIANS LLC flagged for Medicaid fraud?

NORTHWEST EMERGENCY PHYSICIANS LLC (NPI: 1235172370) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does NORTHWEST EMERGENCY PHYSICIANS LLC bill Medicaid?

NORTHWEST EMERGENCY PHYSICIANS LLC received $0.1B in total Medicaid payments from 2018-2024, based on HHS billing records. They are classified as a Emergency Medicine provider. Located in ARLINGTON, WA.

What is NPI 1235172370?

NPI 1235172370 is the National Provider Identifier for NORTHWEST EMERGENCY PHYSICIANS LLC. They are a Emergency Medicine provider based in ARLINGTON, WA. This NPI is registered with the CMS NPI Registry.

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NORTHWEST EMERGENCY PHYSICIANS LLC

Emergency Medicine·ARLINGTON, WA·NPI: 1235172370Share

Compared to Emergency Medicine Peers

Total spending distribution among 11 providers in this specialty

P25MedianP75P90

This provider's total spending of $79.6M is at the 50th percentile among 11 Emergency Medicine providers.

Active Billing Period:2018-01→2024-11(83 months)

Total Paid

$79.6M

$79,550,788

Total Claims

1.4M

Beneficiaries

1.4M

1.0 claims/patient

Avg Cost/Claim

$55

Monthly Spending Trend

Yearly Spending

2018

$12.4M

-7%

2019

$11.6M

-22%

2020

$9.0M

+19%

2021

$10.8M

+23%

2022

$13.2M

-5%

2023

$12.6M

-21%

2024

$10.0M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 11 distinct procedure codes. The top code (99285 (Emergency dept visit, high/urgent complexity)) accounts for 47% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

99285Emergency dept visit, high/urgent complexitySee all providers →

$37.5M

433K claims

$86.71

$85.65

1.0×

Normal range

99285Normal range

Emergency dept visit, high/urgent complexity

$37.5M

433K claims · 47.2%

Your Cost: $86.71/claim|Median: $85.65

1.0× median

99284Emergency dept visit, high complexitySee all providers →

$28.5M

411K claims

$69.28

$69.51

1.0×

Normal range

99284Normal range

Emergency dept visit, high complexity

$28.5M

411K claims · 35.8%

Your Cost: $69.28/claim|Median: $69.51

1.0× median

99283Emergency dept visit, moderate complexitySee all providers →

$10.8M

272K claims

$39.83

$42.48

0.9×

Normal range

99283Normal range

Emergency dept visit, moderate complexity

$10.8M

272K claims · 13.6%

Your Cost: $39.83/claim|Median: $42.48

0.9× median

99291Critical care, first 30-74 minutesSee all providers →

$1.5M

15K claims

$98.92

$101.24

1.0×

Normal range

99291Normal range

Critical care, first 30-74 minutes

$1.5M

15K claims · 1.9%

Your Cost: $98.92/claim|Median: $101.24

1.0× median

99053 See all providers →

$603K

127K claims

$4.74

$0.38

12.5×

Normal range

99053Normal range

$603K

127K claims · 0.8%

Your Cost: $4.74/claim|Median: $0.38

12.5× median

93010Electrocardiogram, interpretation and report onlySee all providers →

$594K

177K claims

$3.35

$5.60

0.6×

Normal range

93010Normal range

Electrocardiogram, interpretation and report only

$594K

177K claims · 0.7%

Your Cost: $3.35/claim|Median: $5.60

0.6× median

99292 See all providers →

$23K

276 claims

$85.07

$57.64

1.5×

Top 25%

99292Top 25%

$23K

276 claims · 0.0%

Your Cost: $85.07/claim|Median: $57.64

1.5× median

99282Emergency dept visit, low complexitySee all providers →

$6K

233 claims

$26.92

$37.72

0.7×

Normal range

99282Normal range

Emergency dept visit, low complexity

$6K

233 claims · 0.0%

Your Cost: $26.92/claim|Median: $37.72

0.7× median

71046Chest X-ray, 2 viewsSee all providers →

$897

735 claims

$1.22

$8.92

0.1×

Normal range

71046Normal range

Chest X-ray, 2 views

$897

735 claims · 0.0%

Your Cost: $1.22/claim|Median: $8.92

0.1× median

71045Chest X-ray, single viewSee all providers →

$525

288 claims

$1.82

$4.93

0.4×

Normal range

71045Normal range

Chest X-ray, single view

$525

288 claims · 0.0%

Your Cost: $1.82/claim|Median: $4.93

0.4× median

99406 See all providers →

$19

3,585 claims

$0.01

$6.53

0.0×

Normal range

99406Normal range

$19

3,585 claims · 0.0%

Your Cost: $0.01/claim|Median: $6.53

0.0× median

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