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.

Ear Nose And Throat Consultants And Hearing Services Plc (NPI 1114141546)

Ear Nose And Throat Consultants And Hearing Services Plc is a otolaryngology physician provider located in Dakota Dunes, South Dakota. This profile covers 0 Medicare and 24 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	Ear Nose And Throat Consultants And Hearing Services Plc
Address	101 Tower Rd
City	Dakota Dunes
State	SD
ZIP	57049
Taxonomy	Otolaryngology Physician
NPI Enumerated	April 13, 2007

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

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

24 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…	8,950	$60	$555K
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…	12,940	$30	$427.1K
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…	8,030	$50	$401.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,290	$200	$250.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	2,320	$50	$113.6K
95117	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives 2 or more injections at a single visit.	5,870	$20	$88K
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.	5,500	$10	$77K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	3,840	$20	$69.2K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	200	$250	$49.4K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	960	$30	$32.7K

Showing 1–10 of 24

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

Ear Nose And Throat Consultants And Hearing Services Plc — 3 of 24 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

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	33	340	1,010	$100	$511K
92526	The provider treats a swallowing disorder through medications, rehabilitation, or a feeding tube, to identify the cause of improper functioning.	5	10	110	$40	$284.6K
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…	21	260	860	$80	$222.6K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	17	60	1,050	$20	$108.2K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	2	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,…	149	160	210	$120	$97.4K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	13	50	400	$30	$76.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	4	10	120	$510	$66.4K
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…	2	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…	29	80	120	$80	$61.5K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Leah Noel	SD	Physical Therapist	$68.2K	$0
Sarah Powell	SD	Otolaryngology Physician	$63.5K	$0
Sarah Sitzmann-ruehle	SD	Physical Therapist	$62.3K	$0
Thomas Kenny	SD	Otolaryngology Physician	$51.1K	$0
Jessica Bowman	SD	Family Nurse Practitioner	$44.2K	$0
Reason Ford	SD	Otolaryngology Physician	$42.2K	$0
Jillian Mcdonnell	IA	Physical Therapist	$36.4K	$0
Brooke Buum	SD	Family Nurse Practitioner	$26.7K	$0
Samantha Protexter	SD	Physical Therapist	$23.1K	$0
Mallory Hertz	SD	Physical Therapist	$21.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cnos PC	SD	Orthopaedic Surgery Physician	$0	$3.6M
Dunes Dental 4 Kids, LLP	SD	Pediatric Dentistry	$0	$3.3M
Chad Laurich	SD	Vascular Surgery Physician	$3.2M	$0
Liem Som Oei Md PC	SD	Nephrology Physician	$0	$2.4M
Oral Surgery Assocates, P.C.	SD	Oral and Maxillofacial Surgery (Dentist)	$0	$2.1M
Dunes Anesthesia PC	SD	Pain Medicine (Anesthesiology) Physician	$0	$1.1M
Midlands Clinic, P.C.	SD	Specialist	$0	$822.9K
Dunes Medical Laboratories	SD	Clinical Medical Laboratory	$303K	$416.6K
Beth Bruening	SD	Ophthalmology Physician	$704.9K	$2.2K
Neal Khurana	SD	Vascular & Interventional Radiology Physician	$704.3K	$0

Ear Nose And Throat Consultants And Hearing Services Plc — Billing Profile & Reimbursement Data

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Ear Nose And Throat Consultants And Hearing Services Plc — 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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