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

Why is the Medicaid comparison limited to Nebraska 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. Nebraska (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.

Ent Specialists PC (NPI 1043282668)

Ent Specialists PC is a otolaryngology physician provider located in Omaha, Nebraska. This profile covers 0 Medicare and 13 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Ent Specialists PC
Address	720 N 129th St
City	Omaha
State	NE
ZIP	68154
Taxonomy	Otolaryngology Physician
NPI Enumerated	February 7, 2006

Payer Source	Total Paid
Medicaid	$347.8K
Medicare	$0

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

13 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	430	$270	$117.9K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	1,960	$30	$66.6K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	3,130	$10	$31.3K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	550	$50	$29.7K
92558	In this procedure, the provider passes low intensity sounds through the ear and measures the reflected sound to analyze hearing deficiencies in newborn babies and small children who are not able to…	1,750	$20	$26.3K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	420	$60	$24K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	250	$90	$23.1K
31526	The provider uses a laryngoscope to look directly inside the larynx, which is the voice box, to detect any abnormality. To properly visualize difficult areas, the provider uses an operating telescope…	70	$160	$10.9K
31622	In this procedure, the provider performs diagnostic rigid or flexible bronchoscopy, a test to view airways and diagnose lung disease. He may or may not use fluoroscopic guidance to perform this test.…	140	$70	$9.2K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	120	$50	$5.7K

Showing 1–10 of 13

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Nebraska Distribution

Ent Specialists PC — 3 of 13 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Nebraska

Full comparison — all codes billed, vs. Nebraska median

13 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	7	20	240	$900	$448.5K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	235	700	660	$70	$305.1K
92587	Code 92587 is in the Medicine/Special Otorhinolaryngologic Services Section. It involves special procedures of the ears/nose/throat. This code is for screening purposes with interpretation and…	2	10	50	$220	$285K
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	311	600	610	$70	$251.4K
31622	In this procedure, the provider performs diagnostic rigid or flexible bronchoscopy, a test to view airways and diagnose lung disease. He may or may not use fluoroscopic guidance to perform this test.…	1	10	90	$530	$49.2K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	56	190	130	$70	$48.5K
99204	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…	45	130	130	$90	$43.8K
92567	In this procedure, the provider measures the functioning of the middle ear by varying the pressure of air presented to the ear to identify the reason for hearing loss.	3	20	480	$20	$32.1K
92504	In this diagnostic procedure, the provider uses a microscope to examine the ears of a patient. He may also sometimes examine the patient’s nose for direct visualization to help with diagnosis…	6	10	70	$20	$13.6K
92558	In this procedure, the provider passes low intensity sounds through the ear and measures the reflected sound to analyze hearing deficiencies in newborn babies and small children who are not able to…	1	10	880	$10	$13K

Showing 1–10 of 13

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Louis Sully	NE	Medical Physician Assistant	$46.7K	$0
Patrick Farrell	IA	Otolaryngology Physician	$21.5K	$0
David Denman	NE	Otolaryngology Physician	$19.1K	$0
Misty Mueller	NE	Audiologist	$9.3K	$0
Brenda Ohlrich	NE	Audiologist	$6.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kubat Pharmacy, LLC	NE	Durable Medical Equipment & Medical Supplies	$0	$4.1M
William Thomas	NE	Ophthalmology Physician	$2.7M	$0
Omega Surgery Center LLC	NE	Ambulatory Surgical Clinic/Center	$1.7M	$359.6K
Aria Eye Care, LLC	NE	Optometrist	$0	$2M
Diagnostic Radiology PC	NE	Diagnostic Radiology Physician	$0	$1.6M
Senior Vision Services LLC	NE	Optometrist	$0	$1.5M
Maxability Therapy Services, P.C.	NE	Speech-Language Pathologist	$0	$1.3M
Cord Where Science Meets Connection LLC	NE	Mental Health Counselor	$0	$1.1M
Verve Collaborative Health LLC	NE	Psychiatric/Mental Health Nurse Practitioner	$0	$804.3K
Miracle Hills Surgery Center LLC	NE	Ambulatory Surgical Clinic/Center	$719K	$56.8K

Ent Specialists PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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