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

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

Southern Utah Ear Nose & Throat LLC (NPI 1679733869)

Southern Utah Ear Nose & Throat LLC is a otolaryngology physician provider located in St George, Utah. 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	Southern Utah Ear Nose & Throat LLC
Address	1490 E Foremaster Dr
City	St George
State	UT
ZIP	84790
Taxonomy	Otolaryngology Physician
NPI Enumerated	June 11, 2008

Payer Source	Total Paid
Medicaid	$539.5K
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…	2,960	$60	$177.5K
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…	1,800	$80	$144.1K
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…	990	$80	$76.9K
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…	600	$110	$67.2K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	110	$210	$23.6K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	480	$30	$12.3K
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.	1,490	$10	$10.4K
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.	1,410	$10	$8.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	70	$90	$6K
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.	40	$110	$4.8K

Showing 1–10 of 15

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Southern Utah Ear Nose & Throat LLC — 1 of 14 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah 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…	322	1,340	200	$80	$144K
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…	145	1,360	190	$70	$125K
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…	38	270	80	$100	$41.6K
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	10	50	$80	$40.3K
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…	21	290	100	$70	$37.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	3	10	80	$140	$37.1K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	10	10	90	$80	$26.8K
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.	4	10	240	$50	$15.1K
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.	6	10	70	$30	$9K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	2	20	120	$30	$6.6K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Grant Needham	UT	Physician Assistant	$227.5K	$0
Joseph Jacob	UT	Otolaryngology Physician	$186.3K	$3.3K
Andrew Vaughan	UT	Otolaryngology Physician	$145.4K	$2.1K
Steven Chase	UT	Otolaryngology Physician	$143.5K	$1.3K
Brandon Cardon	UT	Otolaryngology Physician	$79.7K	$0
Kent Gardner	UT	Facial Plastic Surgery Physician	$68K	$0
Steven Lewis	UT	Audiologist	$16.6K	$40
Brittany Garcia	UT	Audiologist	$14K	$0
Dane Whittaker	UT	Audiologist	$13.3K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Southwest Utah Community Health Center	UT	Federally Qualified Health Center (FQHC)	$0	$7.3M
Zion Eye Institute, Inc	UT	Ambulatory Surgical Clinic/Center	$6.1M	$19.7K
Summit Behavior Services	UT	Counselor	$0	$5.4M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$4.4M
Ron Lord	UT	Ophthalmology Physician	$3.2M	$0
Joshua Carlson	UT	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
St George Surgical Center LP	UT	Ambulatory Surgical Clinic/Center	$2.5M	$0
Coral Desert Surgery Center LLC	UT	Ambulatory Surgical Clinic/Center	$2.5M	$17.8K
Ihc Health Services Inc	UT	Clinical Medical Laboratory	$2.4M	$42.7K

Southern Utah Ear Nose & Throat LLC — Billing Profile & Reimbursement Data

Sign up for Southern Utah Ear Nose & Throat LLC — Billing Profile & Reimbursement Data policy alerts

Southern Utah Ear Nose & Throat LLC — Billing Profile & Reimbursement Data

Sign up for Southern Utah Ear Nose & Throat LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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