Physician
Essex Gastro Associates, PA
Essex Gastro Associates, PA was paid $1.11M by Medicaid between Jan 2018 and Nov 2024, across 26 billing codes. Its largest line is 43239, Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple — 40% of everything it billed.
33Billing provider infoESSEX GASTRO ASSOCIATES, PA
NEWARK, NJ 07105
NEWARK, NJ 07105
33aNPI1114933926assigned 08/01/2006
33bProvider typeGastroenterology Physician
28Total paid$1.11M
24GClaims15,960
24DCodes billed26
24AFirst – last monthJan 2018 – Nov 2024
Compared with peers
Next to other Gastroenterology Physician providers in New Jersey
Rank by total paid#6 of 150
Median peer was paid$27K
This provider vs. median42×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 1,638 | $123K | |
| 2019 | 1,463 | $117K | |
| 2020 | 1,677 | $131K | |
| 2021 | 2,541 | $186K | |
| 2022 | 3,220 | $220K | |
| 2023 | 3,220 | $208K | |
| 2024incomplete | 2,201 | $122K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 40% | 3,058 | 3,020 | $440K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 12% | 581 | 566 | $135K |
| 00731 | 9.4% | 2,478 | 2,411 | $105K | |
| 99214 | Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity | 8.2% | 2,270 | 2,219 | $91K |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 7.9% | 2,505 | 2,482 | $88K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | 7.7% | 622 | 605 | $85K |
| 99244 | Office or other outpatient consultation, moderate to high complexity | 6.3% | 651 | 651 | $70K |
| 99204 | Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 2.5% | 460 | 452 | $28K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 2.3% | 383 | 369 | $26K |
| 00811 | 1.5% | 426 | 417 | $16K | |
| 00812 | 1.4% | 486 | 476 | $16K | |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | <1% | 46 | 46 | $7K |
14 more codes
| 88313 | <1% | 175 | $174.00 | |
| 88312 | <1% | 127 | $81.00 | |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 0% | 333 | $0.00 |
| 1036F | 0% | 237 | $0.00 | |
| G8428 | Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given | 0% | 65 | $0.00 |
| G8419 | Bmi documented outside normal parameters, no follow-up plan documented, no reason given | 0% | 81 | $0.00 |
| G9903 | Patient screened for tobacco use and identified as a tobacco non-user | 0% | 236 | $0.00 |
| G8754 | Most recent diastolic blood pressure < 90 mmhg | 0% | 124 | $0.00 |
| 88342 | 0% | 188 | $0.00 | |
| 3017F | 0% | 155 | $0.00 | |
| G8484 | Influenza immunization was not administered, reason not given | 0% | 56 | $0.00 |
| G8752 | Most recent systolic blood pressure < 140 mmhg | 0% | 53 | $0.00 |
| G8427 | Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications | 0% | 140 | $0.00 |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 24 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGUERRERO, FIRPO (PRESIDENT)