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.

Iowa Ent Center PLLC (NPI 1528314960)

Iowa Ent Center PLLC is a otolaryngology physician provider located in West Des Moines, Iowa. This profile covers 0 Medicare and 15 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	Iowa Ent Center PLLC
Address	105 Valley West Dr
City	West Des Moines
State	IA
ZIP	50265
Taxonomy	Otolaryngology Physician
NPI Enumerated	August 2, 2012

Payer Source	Total Paid
Medicaid	$864.8K
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	9,480	$30	$303.5K
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…	2,470	$70	$160.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	690	$150	$105.4K
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.	6,370	$10	$89.2K
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…	1,170	$40	$46.9K
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…	940	$50	$45K
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…	380	$90	$35.4K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	140	$220	$30.3K
31579	The provider uses a flexible or rigid laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. He also performs stroboscopy, which is a method of examination…	160	$150	$25.1K
T1013	Sign language or oral interpretive services, per 15 minutes	190	$60	$11.8K

Showing 1–10 of 15

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

Iowa Ent Center PLLC — 1 of 14 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

15 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…	429	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	9	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…	161	1,310	760	$20	$153.1K
T1013	Sign language or oral interpretive services, per 15 minutes	17	30	300	$40	$112.3K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	7	30	60	$750	$96.1K
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…	6	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…	74	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…	27	430	110	$50	$36.1K
31579	The provider uses a flexible or rigid laryngoscope to look inside the larynx, or voice box, to detect the presence of any abnormalities. He also performs stroboscopy, which is a method of examination…	1	10	160	$150	$25K
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.	2	50	1,160	$10	$23K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Community Services, Inc.	IA	Point of Service	$261.6K	$46.4M
West Des Moines Community School District	IA	Local Education Agency (LEA)	$0	$11.6M
Stepping Stone Family Services Inc.	IA	Mental Health Counselor	$0	$11.1M
Allergy Institute, P.C.	IA	Allergy & Immunology Physician	$0	$3.4M
Oscar Home Health Care	IA	Home Health Agency	$0	$1.2M
Child Psychiatry Associates PC	IA	Child & Adolescent Psychiatry Physician	$0	$984.2K
Robert Foust	IA	General Practice Dentistry	$0	$898.8K
Pine Acres Assisted Living LLC	IA	Assisted Living Facility	$0	$861.9K
Cody Koch	IA	Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician	$331.9K	$0
Hy-vee Inc	IA	Community/Retail Pharmacy	$249.9K	$16.8K

Iowa Ent Center PLLC — Billing Profile & Reimbursement Data

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Iowa Ent Center PLLC — 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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Simon Wright	IA	Otolaryngology Physician	$131K	$0
Timothy Simplot	IA	Otolaryngology Physician	$96K	$0
David Wonnell	IA	Physician Assistant	$84.1K	$0
Arun Gupta	IA	Otolaryngology Physician	$58.8K	$0
Kevin Prater	IA	Physician Assistant	$33.4K	$0
Stephen Griffith	IA	Otolaryngology Physician	$33K	$0
Joy Hesse	IA	Speech-Language Pathologist	$24.1K	$0
Dorothy Walters	IA	Audiologist	$8.3K	$0
Mariah Jarosh	IA	Audiologist	$4.2K	$0