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

Why is the Medicaid comparison limited to South Dakota 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. South Dakota (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.

Graham Ear, Nose & Throat P.C. (NPI 1063647154)

Field	Value
Entity Type	Organization
Organization	Graham Ear, Nose & Throat P.C.
Address	625 N Foster St Ste 203
City	Mitchell
State	SD
ZIP	57301
Taxonomy	Facial Plastic Surgery Physician
NPI Enumerated	May 19, 2009

Payer Source	Total Paid
Medicaid	$59.7K
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	650	$60	$38.2K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	830	$20	$17.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	10	$200	$2.6K
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…	10	$100	$1.3K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	20	$20	$300

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Dakota Distribution

Graham Ear, Nose & Throat P.C. — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Dakota

Full comparison — all codes billed, vs. South Dakota median

5 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.	11	10	30	$260	$99.6K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	40	160	210	$120	$97.4K
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…	28	100	160	$60	$64.4K
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…	76	80	120	$80	$61.5K
69210	The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.	7	10	80	$20	$5.9K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Graham Ear, Nose & Throat P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
William Graham	SD	Facial Plastic Surgery Physician	$44.4K	$0

Nearby Providers

Other providers in the same ZIP code as Graham Ear, Nose & Throat P.C., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Lifequest	SD	Developmentally Disabled Services Day Training Agency	$0	$53.1M
Abbott House, Inc.	SD	Psychiatric Residential Treatment Facility	$0	$28.1M
Lifequest	SD	Case Manager/Care Coordinator	$0	$13.2M
Dakota Counseling Institute, Inc.	SD	Mental Health Counselor	$0	$9.7M
Dakota Solace Home Care	SD	In Home Supportive Care Agency	$0	$4.9M
Rural Health Care, Inc	SD	Federally Qualified Health Center (FQHC)	$0	$4.4M
Rosewood Court	SD	Assisted Living Facility	$0	$2.7M
Avera Queen Of Peace	SD	Critical Access Hospital	$0	$1.3M
Sanford Clinic	SD	Obstetrics & Gynecology Physician	$0	$1.2M
Dpt Inc	SD	Home Health Agency	$0	$835.1K

Graham Ear, Nose & Throat P.C. — Billing Profile & Reimbursement Data

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Graham Ear, Nose & Throat P.C. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References