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

Why is the Medicaid comparison limited to Rhode Island 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. Rhode Island (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.

University Otolaryngology-head And Neck Surgery, Inc. (NPI 1245350958)

University Otolaryngology-head And Neck Surgery, Inc. is a otolaryngology physician provider located in Providence, Rhode Island. 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	University Otolaryngology-head And Neck Surgery, Inc.
Address	830 Eddy St
City	Providence
State	RI
ZIP	02905
Taxonomy	Otolaryngology Physician
NPI Enumerated	March 29, 2007

Payer Source	Total Paid
Medicaid	$3.5M
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
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…	15,180	$100	$1.4M
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…	5,190	$160	$836.1K
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…	8,290	$60	$480.8K
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.	6,770	$20	$162.5K
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…	1,210	$100	$121.9K
92546	The provider measures various parameters of normal and pathological vestibular systems and also estimates the patient's visual acuity by checking the visual–vestibular interaction using sinusoidal…	210	$540	$113.2K
92544	The provider administers a test to assess the bidirectional movement of the eyes with foveal or peripheral stimulation and records the results.	200	$470	$90.7K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	180	$290	$50K
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…	620	$50	$33.3K
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.	180	$150	$28.2K

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Rhode Island Distribution

University Otolaryngology-head And Neck Surgery, Inc. — 5 of 24 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Rhode Island

Full comparison — all codes billed, vs. Rhode Island median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
92546	The provider measures various parameters of normal and pathological vestibular systems and also estimates the patient's visual acuity by checking the visual–vestibular interaction using sinusoidal…	1	10	210	$540	$113.1K
92544	The provider administers a test to assess the bidirectional movement of the eyes with foveal or peripheral stimulation and records the results.	1	10	200	$470	$90.7K
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…	19	1,730	220	$70	$75.2K
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…	41	2,050	300	$50	$72.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1	10	180	$290	$50K
31575	The provider uses a flexible laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. This code applies to diagnostic services.	3	10	170	$220	$43.3K
92579	The provider performs a battery of tests to evaluate hearing loss in infants and toddlers. He uses sound sources to evaluate the auditory response, with reinforcement by animated toys.	5	10	170	$80	$41.9K
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…	2	300	50	$130	$40.6K
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…	29	350	80	$90	$40.5K
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.	2	10	100	$170	$25.6K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charles Ruhl	RI	Otolaryngology Physician	$66.8K	$687.1K
Pamela Bagdasian	RI	Physician Assistant	$32.5K	$617.3K
Robert Risica	RI	Facial Plastic Surgery Physician	$72.5K	$99.9K
Andrew Burchard	RI	Otolaryngology Physician	$74.6K	$41.8K
Brian Duff	RI	Otology & Neurotology Physician	$74.4K	$2.4K
Melissa Ramocki	RI	Neurology Physician	$68.5K	$0
Rebecca Sochin	RI	Audiologist	$9.9K	$57.6K
Robert Mcrae	RI	Otolaryngology Physician	$48.5K	$6.1K
Maria Koenigs	DC	Otolaryngology Physician	$0	$31.9K
Natalie Silvia	CT	Audiologist	$17.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Women & Infants Hospital Of Rhode Island	RI	General Acute Care Hospital	$0	$132.1M
Elmwood Home Care, Inc.	RI	Home Health Agency	$0	$38.6M
H&t Medicals, Inc	RI	Home Health Agency	$0	$14.8M
R.i.s.a.t., LLC	RI	Methadone Clinic	$321.1K	$14M
Meeting Street Center	RI	Early Intervention Provider Agency	$0	$13.8M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$13.4M
Rhode Island Hospital	RI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$13.2M
Women And Infants Hospital	RI	General Acute Care Hospital	$0	$12.6M
The Providence Community Health Centers, Inc.	RI	Federally Qualified Health Center (FQHC)	$0	$8.3M
Renaissance Adhc, LLC	RI	Adult Day Care Clinic/Center	$0	$7.4M

University Otolaryngology-head And Neck Surgery, Inc. — 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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