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    v1.0.28
    OpenPayerNPI Medicare & MedicaidAshley Balaker
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    Ashley Balaker — Billing Profile & Reimbursement Data

    NPI 1427387547 · Laguna Hills, CA · Otolaryngology Physician

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    Ashley Balaker is a otolaryngology physician provider located in Laguna Hills, California. This profile covers 14 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationAshley Balaker
    Address24411 Health Center Dr Ste 370
    CityLaguna Hills
    StateCA
    ZIP92653
    TaxonomyOtolaryngology Physician
    NPI EnumeratedDecember 19, 2009

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$151.3K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

    The CPT/HCPCS codes generating the most Medicare revenue for this provider.

    14 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99214The 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…470$100$48.7K
    99204The 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…240$130$32.2K
    31231In 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$170$30.1K
    92504In this diagnostic procedure, the provider uses a microscope to examine the ears of a patient. He may also sometimes examine the patient’s nose for direct visualization to help with diagnosis…330$30$8.7K
    99215The 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…50$150$7.5K
    G0268Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing150$40$6.7K
    69220The provider cleans out the cavity left by a mastoidectomy. Patients sometimes require one or more debridement procedures after mastoidectomy before the cavity settles down, i.e., dries out.50$70$3.5K
    70480The provider uses computed tomography, or CT, to examine the eye’s orbit, the sella or posterior fossa of the skull, or the outer, middle, or inner ear. The provider does not administer contrast for…20$150$2.7K
    99205The provider sees a new 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 provider…20$180$2.7K
    95940A provider other than the surgeon or anesthesia staff conducts neurophysiology tests, such as electroncephalography or EEG, electromyography or EMG, evoked potentials or nerve conduction study, to…90$30$2.4K

    Showing 1–10 of 14

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 14 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    14 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    992145,63937,970120$90$23.2K
    3123110754070$100$20.1K
    992157,46315,36050$130$14.4K
    959401520310$30$14.1K
    9921328,11334,66080$70$13.2K
    992056,6848,36030$170$7.2K
    9920442519,36040$120$7.2K
    992039,31512,74030$80$4.6K
    692101,2181,37030$30$4K
    6922083030$60$3K

    Showing 1–10 of 14

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Ashley Balaker, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Joseph SedrakTXMOHS-Micrographic Surgery Physician$4.4M$0
    John HwangCARetina Specialist (Ophthalmology) Physician$1.9M$1.7M
    Charles EifrigCARetina Specialist (Ophthalmology) Physician$2.6M$885K
    Kourosh DastgheibCAOphthalmology Physician$210.8K$3.1M
    Tien NguyenCADermatology Physician$447.5K$2.2M
    Brian KimCAOphthalmology Physician$2.6M$8.9K
    Desmond McguireCARetina Specialist (Ophthalmology) Physician$1.4M$1.1M
    Hema RamkumarCARetina Specialist (Ophthalmology) Physician$2M$54.9K
    Vivian LaquerCADermatology Physician$94.8K$1.7M
    Farah AwadallaCADermatology Physician$1.4M$320K

    Nearby Providers

    Other providers in the same ZIP code as Ashley Balaker, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Wilshire Pharmcare, Inc.CAPharmacy$114.3K$31M
    Pmdca, LLCCAClinical Medical Laboratory$906.1K$7M
    Alicia Surgery Center LLCCAAmbulatory Surgical Clinic/Center$3.2M$0
    Pacific Hills Surgery Center LLCCAAmbulatory Surgical Clinic/Center$1.6M$15.2K
    Brandon MorrisCAFamily Nurse Practitioner$1.4M$0
    Prelude CorporationCAClinical Medical Laboratory$1M$9K
    Ali TabatabaiCASpecialist$1M$0
    Esrafil AbediCAOtolaryngology/Facial Plastic Surgery Physician$101.1K$806.2K
    Savak TeymoorianCAOphthalmology Physician$782.6K$0
    Jason LiauwCANeurological Surgery Physician$668.2K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. California Distribution
    Ashley Balaker — 1 of 14 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California