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

Why is the Medicaid comparison limited to Georgia 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. Georgia (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,& Throat Of Northwest Georgia (NPI 1114986163)

Ear,nose,& Throat Of Northwest Georgia is a otolaryngology physician provider located in Rome, Georgia. This profile covers 0 Medicare and 31 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,& Throat Of Northwest Georgia
Address	107 John Maddox Dr Nw
City	Rome
State	GA
ZIP	30165
Taxonomy	Otolaryngology Physician
NPI Enumerated	March 20, 2006

Payer Source	Total Paid
Medicaid	$2M
Medicare	$0

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

31 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	11,710	$50	$538.7K
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…	7,010	$60	$413.4K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	2,050	$180	$362.1K
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…	1,530	$110	$161.9K
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…	1,680	$70	$117.9K
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.	3,410	$20	$58K
92511	The provider examines the nasal passages and throat with an endoscope, a tubular instrument with a light source and camera.	960	$50	$50.6K
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…	810	$50	$39.5K
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.	1,160	$30	$33.6K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	120	$230	$26.6K

Showing 1–10 of 31

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Georgia Distribution

Ear,nose,& Throat Of Northwest Georgia — 1 of 23 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Georgia

Full comparison — all codes billed, vs. Georgia median

31 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	10	20	190	$1,120	$833.4K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	3	20	260	$560	$608.1K
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…	93	920	370	$60	$360.6K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	3	10	30	$920	$289K
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…	93	820	390	$70	$245K
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…	41	310	90	$90	$136.3K
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…	23	230	100	$110	$97.1K
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…	9	30	510	$50	$71.5K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	69	160	180	$80	$68K
31231	In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.	4	10	80	$60	$54.5K

Showing 1–10 of 31

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dr. Miniyars Pediatrics, P.C.	GA	Pediatrics Physician	$0	$18.8M
Dimple Modi	GA	Retina Specialist (Ophthalmology) Physician	$2.7M	$0
Floyd Physicians, LLC	GA	Neonatal-Perinatal Medicine Physician	$0	$2.6M
Gregory Harris	GA	Hematology & Oncology Physician	$2M	$0
Melissa Dillmon	GA	Hematology & Oncology Physician	$2M	$0
Dilawar Khan	GA	Hematology & Oncology Physician	$1.9M	$0
Amtran Medical Transport Inc	GA	Land Ambulance	$1.8M	$1.7K
Floyd Healthcare Management Inc	GA	Family Medicine Physician	$0	$1.3M
Jeffrey Peller	GA	Rheumatology Physician	$1.1M	$0
Travis Whitehead	GA	Emergency Medicine Physician	$70.8K	$702.1K

Ear,nose,& Throat Of Northwest Georgia — Billing Profile & Reimbursement Data

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Ear,nose,& Throat Of Northwest Georgia — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Raymond Howard	GA	Otolaryngology Physician	$190.8K	$0
Mary Dillard	GA	Family Nurse Practitioner	$34.8K	$0