Is STEWARD EMERGENCY PHYSICIANS, INC flagged for Medicaid fraud?

STEWARD EMERGENCY PHYSICIANS, INC (NPI: 1780971275) has not been flagged by our statistical fraud detection tests. Their billing patterns fall within normal ranges for their specialty.

How much does STEWARD EMERGENCY PHYSICIANS, INC bill Medicaid?

STEWARD EMERGENCY PHYSICIANS, INC 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 AYER, MA.

What is NPI 1780971275?

NPI 1780971275 is the National Provider Identifier for STEWARD EMERGENCY PHYSICIANS, INC. They are a Emergency Medicine provider based in AYER, MA. This NPI is registered with the CMS NPI Registry.

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STEWARD EMERGENCY PHYSICIANS, INC

Emergency Medicine·AYER, MA·NPI: 1780971275Share

Compared to Emergency Medicine Peers

Total spending distribution among 11 providers in this specialty

P25MedianP75P90

This provider's total spending of $58.8M is at the 50th percentile among 11 Emergency Medicine providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$58.8M

$58,820,757

Total Claims

929K

Beneficiaries

911K

1.0 claims/patient

Avg Cost/Claim

$63

Monthly Spending Trend

Yearly Spending

2018

$10.3M

-8%

2019

$9.5M

-17%

2020

$7.9M

+3%

2021

$8.1M

-0%

2022

$8.0M

+7%

2023

$8.6M

-25%

2024

$6.4M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 22 distinct procedure codes. The top code (99284 (Emergency dept visit, high complexity)) accounts for 44% of total spending.

ProcedureTotalYour Cost/ClaimNational Medianvs MedianPercentile

99284Emergency dept visit, high complexitySee all providers →

$26.0M

365K claims

$71.36

$69.51

1.0×

Normal range

99284Normal range

Emergency dept visit, high complexity

$26.0M

365K claims · 44.3%

Your Cost: $71.36/claim|Median: $69.51

1.0× median

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

$25.9M

291K claims

$89.12

$85.65

1.0×

Normal range

99285Normal range

Emergency dept visit, high/urgent complexity

$25.9M

291K claims · 44.1%

Your Cost: $89.12/claim|Median: $85.65

1.0× median

99283Emergency dept visit, moderate complexitySee all providers →

$5.6M

145K claims

$38.73

$42.48

0.9×

Normal range

99283Normal range

Emergency dept visit, moderate complexity

$5.6M

145K claims · 9.5%

Your Cost: $38.73/claim|Median: $42.48

0.9× median

93010Electrocardiogram, interpretation and report onlySee all providers →

$435K

108K claims

$4.05

$5.60

0.7×

Normal range

93010Normal range

Electrocardiogram, interpretation and report only

$435K

108K claims · 0.7%

Your Cost: $4.05/claim|Median: $5.60

0.7× median

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

$306K

3,237 claims

$94.62

$101.24

0.9×

Normal range

99291Normal range

Critical care, first 30-74 minutes

$306K

3,237 claims · 0.5%

Your Cost: $94.62/claim|Median: $101.24

0.9× median

99223Initial hospital care, per day, high complexitySee all providers →

$199K

1,793 claims

$110.75

$67.32

1.6×

Top 25%

99223Top 25%

Initial hospital care, per day, high complexity

$199K

1,793 claims · 0.3%

Your Cost: $110.75/claim|Median: $67.32

1.6× median

99226 See all providers →

$128K

2,364 claims

$54.09

$34.09

1.6×

Top 25%

99226Top 25%

$128K

2,364 claims · 0.2%

Your Cost: $54.09/claim|Median: $34.09

1.6× median

99220 See all providers →

$55K

569 claims

$96.24

$73.56

1.3×

Normal range

99220Normal range

$55K

569 claims · 0.1%

Your Cost: $96.24/claim|Median: $73.56

1.3× median

99231Subsequent hospital care, per day, low complexitySee all providers →

$40K

2,042 claims

$19.54

$16.77

1.2×

Normal range

99231Normal range

Subsequent hospital care, per day, low complexity

$40K

2,042 claims · 0.1%

Your Cost: $19.54/claim|Median: $16.77

1.2× median

99233Subsequent hospital care, per day, high complexitySee all providers →

$29K

484 claims

$60.64

$35.30

1.7×

Top 25%

99233Top 25%

Subsequent hospital care, per day, high complexity

$29K

484 claims · 0.0%

Your Cost: $60.64/claim|Median: $35.30

1.7× median

99217 See all providers →

$25K

655 claims

$37.53

$31.89

1.2×

Normal range

99217Normal range

$25K

655 claims · 0.0%

Your Cost: $37.53/claim|Median: $31.89

1.2× median

99213Office/outpatient visit, est. patient, low-mod complexitySee all providers →

$6K

126 claims

$50.36

$37.81

1.3×

Normal range

99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$6K

126 claims · 0.0%

Your Cost: $50.36/claim|Median: $37.81

1.3× median

99214Office/outpatient visit, est. patient, mod-high complexitySee all providers →

$3K

39 claims

$68.57

$53.41

1.3×

Normal range

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$3K

39 claims · 0.0%

Your Cost: $68.57/claim|Median: $53.41

1.3× median

99232Subsequent hospital care, per day, moderate complexitySee all providers →

$3K

69 claims

$38.74

$23.99

1.6×

Top 25%

99232Top 25%

Subsequent hospital care, per day, moderate complexity

$3K

69 claims · 0.0%

Your Cost: $38.74/claim|Median: $23.99

1.6× median

99238Hospital discharge day management, 30 minutes or lessSee all providers →

$1K

27 claims

$41.43

$37.22

1.1×

Normal range

99238Normal range

Hospital discharge day management, 30 minutes or less

$1K

27 claims · 0.0%

Your Cost: $41.43/claim|Median: $37.22

1.1× median

12001 See all providers →

$830

26 claims

$31.92

$64.99

0.5×

Normal range

12001Normal range

$830

26 claims · 0.0%

Your Cost: $31.92/claim|Median: $64.99

0.5× median

90471Immunization administration, 1 vaccine, percutaneous/ID/SC/IMSee all providers →

$734

41 claims

$17.91

$9.80

1.8×

Top 25%

90471Top 25%

Immunization administration, 1 vaccine, percutaneous/ID/SC/IM

$734

41 claims · 0.0%

Your Cost: $17.91/claim|Median: $9.80

1.8× median

99282Emergency dept visit, low complexitySee all providers →

$603

25 claims

$24.12

$37.72

0.6×

Normal range

99282Normal range

Emergency dept visit, low complexity

$603

25 claims · 0.0%

Your Cost: $24.12/claim|Median: $37.72

0.6× median

12011 See all providers →

$463

12 claims

$38.61

$67.02

0.6×

Normal range

12011Normal range

$463

12 claims · 0.0%

Your Cost: $38.61/claim|Median: $67.02

0.6× median

93042 See all providers →

$204

55 claims

$3.71

$2.53

1.5×

Normal range

93042Normal range

$204

55 claims · 0.0%

Your Cost: $3.71/claim|Median: $2.53

1.5× median

G9744 See all providers →

7,646 claims

$0.00

$0.09

—

Normal range

G9744Normal range

7,646 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.09

G8952 See all providers →

900 claims

$0.00

$0.03

—

Normal range

G8952Normal range

900 claims · 0.0%

Your Cost: $0.00/claim|Median: $0.03

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