Essex Gastroenterology Associates LLC
Essex Gastroenterology Associates LLC was paid $514K by Medicaid between Jan 2018 and Dec 2023, across 17 billing codes. Its largest line is 99213, doctor's office visit, returning patient (routine) — 25% of everything it billed.
33Billing provider infoESSEX GASTROENTEROLOGY ASSOCIATES LLC
BELLEVILLE, NJ 07109
BELLEVILLE, NJ 07109
33aNPI1881665305assigned 02/01/2006
33bProvider typeSpecialist
28Total paid$514K
24GClaims11,792
24DCodes billed17
24AFirst – last monthJan 2018 – Dec 2023
Compared with peers
Next to other Specialist providers in New Jersey
Rank by total paid#88 of 378
Median peer was paid$63K
This provider vs. median8.2×
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 | 1,691 | $85K | |
| 2019 | 1,684 | $89K | |
| 2020 | 1,258 | $52K | |
| 2021 | 2,181 | $100K | |
| 2022 | 3,080 | $119K | |
| 2023 | 1,898 | $68K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 25% | 4,001 | 3,792 | $130K |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | 20% | 2,028 | 1,886 | $103K |
| 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 | 13% | 1,792 | 1,593 | $68K |
| 43239 | Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple | 10% | 617 | 576 | $52K |
| 88305 | Level IV - Surgical pathology, gross and microscopic examination | 8.9% | 1,215 | 947 | $46K |
| 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 | 7.2% | 521 | 480 | $37K |
| 45385 | Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) | 6.6% | 243 | 212 | $34K |
| 45380 | Colonoscopy, flexible; with biopsy, single or multiple | 3.2% | 185 | 176 | $17K |
| 88342 | 1.8% | 337 | 255 | $9K | |
| 99223 | Prolong inpt eval add15 m | <1% | 134 | 121 | $5K |
| 88313 | <1% | 362 | 281 | $4K | |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 196 | 190 | $4K |
5 more codes
| 99222 | Initial hospital care, per day, moderate complexity | <1% | 56 | $3K |
| 45378 | Colonoscopy, flexible; diagnostic, including collection of specimen(s) | <1% | 13 | $2K |
| 99231 | Subsequent hospital care, per day, straightforward or low complexity | <1% | 43 | $789.82 |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 27 | $612.86 |
| 88312 | <1% | 22 | $159.96 |
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, BETSY (PRACTICE ADMINISTRATOR)