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.

Wellendorf Ent, P.C. (NPI 1740494244)

Wellendorf Ent, P.C. is a otolaryngology physician provider located in Carroll, Iowa. This profile covers 0 Medicare and 11 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	Wellendorf Ent, P.C.
Address	405 S Clark St
City	Carroll
State	IA
ZIP	51401
Taxonomy	Otolaryngology Physician
NPI Enumerated	May 10, 2007

Payer Source	Total Paid
Medicaid	$932.9K
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	1,730	$100	$164.6K
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…	3,800	$40	$151.9K
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…	4,710	$30	$150.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	870	$150	$132.7K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	470	$220	$105.7K
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…	1,840	$50	$84.8K
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…	1,200	$60	$71K
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.	4,510	$10	$63.2K
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.	80	$70	$5.2K
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.	110	$20	$2.5K

Showing 1–10 of 11

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

Wellendorf Ent, P.C. — 2 of 11 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

11 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…	318	1,060	480	$40	$154.5K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	5	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…	269	1,310	760	$20	$153.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	2	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…	1	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…	22	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…	57	430	110	$50	$36.1K
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	10	80	$70	$29.4K
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	50	1,160	$10	$23K
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.	13	30	80	$20	$6.2K

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carroll Co Council Prev Child Abuse	IA	Community/Behavioral Health Agency	$0	$51M
New Hope Village, Inc	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$50.2M
Ability United LLC	IA	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$43.8M
Homecare Options, Inc.	IA	Contractor	$0	$9.1M
Caring Hearts Of West Central Iowa	IA	Community Health Worker	$0	$3.4M
Region Xii Council Of Governments, Inc.	IA	Non-emergency Medical Transport (VAN)	$0	$1.9M
St Anthony Regional Hospital And Nursing Home	IA	Critical Access Hospital	$0	$1.4M
Carroll Community School District	IA	Local Education Agency (LEA)	$0	$1.3M
Carroll County County Auditor	IA	Ambulance	$344K	$824.9K
St Anthony Regional Hospital And Nursing Home	IA	Family Medicine Physician	$0	$1.1M

Wellendorf Ent, P.C. — Billing Profile & Reimbursement Data

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Wellendorf Ent, 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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