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

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

Burlington Ear Nose & Throat Clinic PC (NPI 1326157140)

Burlington Ear Nose & Throat Clinic PC is a otolaryngology physician provider located in West Burlington, Iowa. This profile covers 0 Medicare and 20 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	Burlington Ear Nose & Throat Clinic PC
Address	1225 S Gear Ave
City	West Burlington
State	IA
ZIP	52655
Taxonomy	Otolaryngology Physician
NPI Enumerated	August 29, 2006

Payer Source	Total Paid
Medicaid	$907.7K
Medicare	$0

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

20 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…	5,280	$60	$327.2K
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…	7,360	$30	$235.5K
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…	2,560	$40	$112.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	460	$170	$78.9K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	160	$220	$34.9K
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…	870	$40	$34.8K
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.	1,800	$10	$25.2K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	160	$110	$17.4K
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…	590	$30	$17.1K
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.	180	$70	$12.7K

Showing 1–10 of 20

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Iowa Distribution

Burlington Ear Nose & Throat Clinic PC — 1 of 16 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Iowa

Full comparison — all codes billed, vs. Iowa median

20 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…	440	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	16	50	170	$410	$153.8K
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…	196	1,310	760	$20	$153.1K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	18	20	510	$110	$112.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	5	30	60	$750	$96.1K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	20	30	410	$120	$79.2K
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.	24	30	1,150	$10	$52.3K
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…	3	30	210	$70	$47.7K
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…	214	250	110	$80	$47.1K
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…	14	430	110	$50	$36.1K

Showing 1–10 of 20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Douglas Henrich	IA	Otolaryngology Physician	$198.1K	$101.9K
Jennifer Berge	IA	Otolaryngology Physician	$97.5K	$29K
Carly Williams	IA	Audiologist	$19.2K	$800

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Community Health Centers Of Southeastern Iowa Inc	IA	Federally Qualified Health Center (FQHC)	$0	$35.3M
Southeast Iowa Regional Medical Center, Inc.	IA	General Acute Care Hospital	$0	$21.2M
Southeast Iowa Regional Medical Center, Inc.	IA	General Practice Physician	$0	$12.3M
Community Health Center Of Seia, Inc	IA	Dentist	$0	$3.7M
Burlington Pediatric Association, P.C.	IA	Pediatrics Physician	$0	$1.8M
Burlington Neurology And Sleep Clinic, Plc	IA	Neurology Physician	$0	$1.2M
Aneesh Neekhra	IA	Neurology Physician	$210.9K	$234.4K
Michael Abouassaly	IA	Family Medicine Physician	$275K	$0
Eric O'brien	IA	Optometrist	$45.6K	$204.5K
Louis Kantzavelos	IA	Urology Physician	$213.8K	$0

Burlington Ear Nose & Throat Clinic PC — Billing Profile & Reimbursement Data

Sign up for Burlington Ear Nose & Throat Clinic PC — Billing Profile & Reimbursement Data policy alerts

Burlington Ear Nose & Throat Clinic 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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