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.

Otolaryngology Consultants Of Memphis, P.C. (NPI 1558487918)

Otolaryngology Consultants Of Memphis, P.C. is a specialist provider located in Memphis, Tennessee. This profile covers 0 Medicare and 27 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	Otolaryngology Consultants Of Memphis, P.C.
Address	791 Estate Pl
City	Memphis
State	TN
ZIP	38120
Taxonomy	Specialist
NPI Enumerated	March 21, 2007

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

27 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.	7,130	$80	$591.5K
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…	14,160	$30	$424.7K
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…	5,270	$50	$236.9K
70486	The provider uses computed tomography, or CT, to examine the maxillofacial area, such as the upper jaw or face structures. The provider does not administer contrast for this exam.	2,840	$60	$173.4K
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.	1,590	$70	$106.2K
99202	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…	2,030	$40	$79.1K
92552	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the lowest threshold at which the patient can hear.	7,140	$10	$78.5K
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.	1,750	$40	$71.9K
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.	8,970	$10	$71.7K
31237	In this procedure, the provider inserts an endoscope into the nasal cavity. She examines the nasal contents. The provider then performs a nasal biopsy, polypectomy, or debridement.	940	$70	$63.7K

Showing 1–10 of 27

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

Otolaryngology Consultants Of Memphis, P.C. — 9 of 25 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

27 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.	30	50	140	$850	$541.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	30	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.	20	80	330	$170	$342.3K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	50	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…	297	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.	71	110	650	$10	$105.4K
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.	1	20	210	$90	$53.6K
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…	38	1,240	120	$60	$53.1K
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…	31	100	320	$40	$36.6K
31237	In this procedure, the provider inserts an endoscope into the nasal cavity. She examines the nasal contents. The provider then performs a nasal biopsy, polypectomy, or debridement.	1	10	490	$70	$36.3K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Baptist Memorial Hospital	TN	General Acute Care Hospital	$0	$51.4M
East Memphis Neonatology Associates P.C	TN	Neonatal-Perinatal Medicine Physician	$0	$20.7M
Semmes-murphey Clinic PC	TN	Ambulatory Surgical Clinic/Center	$4.1M	$11K
Lebonheur East Surgery Center Ii LP	TN	Ambulatory Surgical Clinic/Center	$0	$3M
Ridge Lake Asc, LLC	TN	Ophthalmologic Surgery Clinic/Center	$2.4M	$390.5K
Vrf Eye Specialty Group, Plc	TN	Ophthalmology Physician	$0	$2.5M
Gastrointestinal Specialists Foundation, Inc	TN	Gastroenterology Physician	$0	$2.5M
George Woodman	TN	Surgery Physician	$1.1K	$2.3M
Obgyn Consultants Of Memphis	TN	Obstetrics & Gynecology Physician	$0	$2.1M
Mays & Schnapp Pain Clinic & Rehabilitation Center	TN	Ambulatory Surgical Clinic/Center	$1.5M	$0

Otolaryngology Consultants Of Memphis, P.C. — 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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