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

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

Rocky Mountain Ear Nose & Throat Center PC (NPI 1306857917)

Rocky Mountain Ear Nose & Throat Center PC is a otolaryngology physician provider located in Missoula, Montana. 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	Rocky Mountain Ear Nose & Throat Center PC
Address	700 West Kent
City	Missoula
State	MT
ZIP	59801
Taxonomy	Otolaryngology Physician
NPI Enumerated	August 10, 2006

Payer Source	Total Paid
Medicaid	$228.4K
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
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…	440	$150	$65.4K
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…	430	$120	$49.6K
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…	1,720	$20	$36K
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…	320	$90	$28.4K
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.	1,800	$10	$19.8K
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.	120	$90	$11K
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…	70	$130	$9.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	30	$260	$6.4K
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.	10	$80	$1.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	20	$50	$810

Showing 1–10 of 24

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Montana Distribution

Rocky Mountain Ear Nose & Throat Center PC — 0 of 12 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Montana

Full comparison — all codes billed, vs. Montana median

24 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	419	530	580	$70	$224.6K
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…	333	520	730	$40	$196.4K
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	120	$180	$60.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	14	20	30	$400	$56.1K
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…	28	130	100	$120	$49.4K
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…	51	190	130	$70	$37.2K
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…	2	10	400	$20	$16.6K
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.	5	20	340	$10	$12.1K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	82	100	60	$40	$10.3K
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.	6	10	60	$30	$4.9K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Todd Murdock	MT	Ophthalmology Physician	$103.7K	$1M
Jonathan Fowlkes	MT	Otolaryngology Physician	$100.5K	$121.8K
Phillip Gardner	MT	Otolaryngology Physician	$29.9K	$179.3K
Josh Moser	MT	Physician Assistant	$83.1K	$68K
Duncan Watley	MT	Otolaryngology Physician	$128.8K	$3.9K
Peter Vondoersten	MT	Otolaryngology Physician	$63K	$40.3K
Jeffrey Haller	MT	Otolaryngology Physician	$48.2K	$5.8K
Marissa Cadena	MT	Physician Assistant	$39.6K	$5.2K
Emily Yelenich	MT	Family Nurse Practitioner	$21.3K	$0
Kevin Duffy	MT	Audiologist	$18.6K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Western Montana Mental Health Center	MT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$87.8M
Opportunity Resources Inc	MT	Developmentally Disabled Services Day Training Agency	$0	$48.5M
Missoula Developmental Service Corp	MT	Non-emergency Medical Transport (VAN)	$0	$33.6M
Express Personnel Services	MT	Nursing Care Agency	$0	$20.4M
3 Rivers Mental Health Solutions LLC	MT	Community/Behavioral Health Agency	$0	$16.7M
Missoula County Public Schools	MT	Local Education Agency (LEA)	$0	$16.3M
Meadowlark Home Care LLC	MT	Home Health Agency	$0	$12.9M
Client Dedicated Services, Inc	MT	Home Health Agency	$0	$10.6M
Children's Dentistry Of The Rockies	MT	Pediatric Dentistry	$0	$10.1M
Missoula Pediatric Dentistry PC	MT	Pediatric Dentistry	$0	$9.3M

Rocky Mountain Ear Nose & Throat Center PC — Billing Profile & Reimbursement Data

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Rocky Mountain Ear Nose & Throat Center 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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