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

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

East Tennessee Ear, Nose & Throat Specialists, PC (NPI 1467552216)

East Tennessee Ear, Nose & Throat Specialists, PC is a otolaryngology physician provider located in Oak Ridge, Tennessee. This profile covers 0 Medicare and 22 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	East Tennessee Ear, Nose & Throat Specialists, PC
Address	800 Oak Ridge Turnpike
City	Oak Ridge
State	TN
ZIP	37830
Taxonomy	Otolaryngology Physician
NPI Enumerated	September 22, 2006

Payer Source	Total Paid
Medicaid	$2.6M
Medicare	$0

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

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	8,850	$80	$690.5K
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…	12,620	$30	$403.7K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	2,890	$90	$263K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	1,750	$130	$220.5K
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…	4,150	$40	$182.8K
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.	19,960	$10	$179.7K
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…	1,830	$80	$146.2K
95115	The provider injects the patient with allergenic extracts to desensitize the patient to the allergen; the patient receives a single injection during the visit.	12,000	$10	$72K
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…	1,250	$50	$67.4K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	410	$160	$66.5K

Showing 1–10 of 22

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Tennessee Distribution

East Tennessee Ear, Nose & Throat Specialists, PC — 2 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Tennessee

Full comparison — all codes billed, vs. Tennessee median

22 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.	21	50	140	$850	$541.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	23	70	160	$500	$421.5K
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.	4	80	330	$170	$342.3K
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…	667	3,760	610	$40	$202.3K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	26	70	130	$140	$193.9K
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	4,050	620	$30	$183.9K
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.	9	110	650	$10	$105.4K
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…	97	1,080	120	$80	$90.7K
99244	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider…	7	90	100	$140	$77.4K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	7	70	90	$90	$59.9K

Showing 1–10 of 22

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ridgeview Psychiatric Hospital And Center, Inc.	TN	Psychiatric Hospital	$0	$42M
Southeastern Physician Services PC	TN	Hospitalist Physician	$0	$14.7M
Emory Valley Center	TN	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$11.3M
Discover Diagnostic Laboratory, LLC	TN	Clinical Medical Laboratory	$363.5K	$4.7M
Children's Clinic	TN	Pediatric Adolescent Medicine Physician	$0	$4.7M
East Tennessee Children's Primary Care Center, Inc.	TN	Pediatrics Physician	$0	$2.4M
The Eye Surgery Center Of Oak Ridge LLC	TN	Clinic/Center	$783K	$3.3K
Surgery Center Of Oak Ridge, LLC	TN	Ambulatory Surgical Clinic/Center	$241K	$493.4K
Brian Burnett	TN	Family Nurse Practitioner	$661.1K	$0
Joseph Eatherly	TN	Specialist	$394.3K	$3.9K

East Tennessee Ear, Nose & Throat Specialists, PC — Billing Profile & Reimbursement Data

Sign up for East Tennessee Ear, Nose & Throat Specialists, PC — Billing Profile & Reimbursement Data policy alerts

East Tennessee Ear, Nose & Throat Specialists, PC — Billing Profile & Reimbursement Data

Sign up for East Tennessee Ear, Nose & Throat Specialists, PC — Billing Profile & Reimbursement Data policy alerts

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
Jonathan Hafner	TN	Otolaryngology Physician	$243.3K	$0
Brynae Miley	TN	Otolaryngology Physician	$133.1K	$0
Frederick Bunge	TN	Otolaryngology Physician	$119K	$0
Charles Sewall	TN	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	$97.6K	$0
Cassandra Hall	TN	Audiologist	$8.2K	$0