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

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

Wilmington Otolaryngology Associates, PA (NPI 1518902451)

Field	Value
Entity Type	Organization
Organization	Wilmington Otolaryngology Associates, PA
Address	2300 Pennsylvania Ave
City	Wilmington
State	DE
ZIP	19806
Taxonomy	Otolaryngology Physician
NPI Enumerated	June 17, 2006

Payer Source	Total Paid
Medicaid	$86.2K
Medicare	$0

Medicaid: Complete Services Breakdown

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

5 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	450	$80	$34.7K
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…	810	$30	$27.4K
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…	330	$30	$10.2K
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…	250	$30	$8.3K
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.	430	$10	$5.6K

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Delaware Distribution

Wilmington Otolaryngology Associates, PA — 0 of 5 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Delaware

Full comparison — all codes billed, vs. Delaware median

5 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…	359	500	1,130	$50	$235.1K
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…	305	540	1,100	$40	$185.3K
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.	2	10	240	$120	$133.6K
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…	75	190	240	$60	$90.8K
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.	4	10	200	$30	$17.7K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Wilmington Otolaryngology Associates, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jay Luft	DE	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	$177.6K	$0

Nearby Providers

Other providers in the same ZIP code as Wilmington Otolaryngology Associates, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Nancy Pancko	DE	Orthodontics and Dentofacial Orthopedics Dentistry	$0	$10M
Ingleside Homes, Inc	DE	Assisted Living Facility	$0	$2.5M
Paula Ko	DE	Ophthalmology Physician	$1.7M	$0
Liberty Dialysis - Wilmington LLC	DE	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.6M
Eye Physicians & Surgeons, PA	DE	Ophthalmology Physician	$0	$1.6M
Brandywine Medical Associates, Inc.	DE	Family Medicine Physician	$0	$1.3M
Brian Toussaint	DE	Ophthalmology Physician	$1.2M	$0
Ingleside Homes, Inc	DE	Homemaker	$0	$1.2M
Rmb Group, LLC	DE	In Home Supportive Care Agency	$0	$1.1M
Philip Schwartz	DE	Rheumatology Physician	$937.1K	$0

Wilmington Otolaryngology Associates, PA — Billing Profile & Reimbursement Data

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Wilmington Otolaryngology Associates, PA — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References