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

Why is the Medicaid comparison limited to South Carolina 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. South Carolina (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.

Charleston Ent Associates, LLC (NPI 1588607303)

Charleston Ent Associates, LLC is a otolaryngology physician provider located in Charleston, South Carolina. This profile covers 0 Medicare and 39 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	Charleston Ent Associates, LLC
Address	2295 Henry Tecklenburg Dr
City	Charleston
State	SC
ZIP	29414
Taxonomy	Otolaryngology Physician
NPI Enumerated	June 13, 2006

Payer Source	Total Paid
Medicaid	$7.1M
Medicare	$0

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

39 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	19,080	$80	$1.6M
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…	28,560	$50	$1.5M
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…	10,320	$120	$1.2M
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.	4,760	$120	$575.5K
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.	1,500	$240	$361.8K
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…	2,430	$140	$337.4K
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.	15,330	$10	$199.3K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	220	$820	$178.3K
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.	24,250	$10	$169.8K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	1,030	$150	$151.3K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. South Carolina Distribution

Charleston Ent Associates, LLC — 7 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — South Carolina

Full comparison — all codes billed, vs. South Carolina median

39 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	11	20	380	$520	$421.9K
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.	12	40	120	$220	$367.6K
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…	91	2,770	210	$60	$254.5K
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…	75	2,480	350	$80	$246K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	14	30	860	$130	$203.7K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	21	40	120	$330	$201.6K
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…	8	110	70	$150	$157.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	19	50	480	$160	$147.9K
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	30	170	$120	$120.1K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	95	610	190	$50	$98.4K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Charleston Ent Associates, LLC	SC	Ambulatory Surgical Clinic/Center	$482K	$2.8M
David Maurer	SC	Otolaryngology Physician	$485K	$0
James Russell	AR	Otolaryngology Physician	$326.6K	$0
Julien Norton	SC	Otolaryngology Physician	$323.4K	$2.3K
Don Christian	SC	Otolaryngology Physician	$319.7K	$800
Leslie Scarlett	SC	Ophthalmology Physician	$274K	$0
Edward Mcnellis	SC	Otolaryngology Physician	$209.7K	$0
Eugene Brown	SC	Otolaryngology Physician	$199K	$0
Thomas Hester	SC	Otology & Neurotology Physician	$188.3K	$2.1K
Mark Ghegan	SC	Otolaryngology Physician	$189K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
South Carolina Dept Of Mental Health Accounting Office	SC	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$65.9M
Bon Secours St. Francis Xavier Hospital Inc.	SC	General Acute Care Hospital	$0	$35.9M
Coastal Pediatric Associates, P.A.	SC	Pediatrics Physician	$0	$25M
Eric Jablon	SC	Ophthalmology Physician	$8.9M	$0
John Kerrison	SC	Ophthalmology Physician	$5M	$0
Charleston Neurosciences Institute	SC	Ophthalmology Physician	$0	$4.2M
Physicians Eye Surgery Center LLC	SC	Ambulatory Surgical Clinic/Center	$3.9M	$70.1K
Daniel Alfaro	SC	Ophthalmology Physician	$3.6M	$0
Michael Johnson	SC	Ophthalmology Physician	$3M	$0
Bon Secours St Francis Xavier Hospital, Inc.	SC	Emergency Medicine Physician	$0	$2.3M

Charleston Ent Associates, LLC — Billing Profile & Reimbursement Data

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Charleston Ent Associates, LLC — 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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