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

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

Ear, Nose & Throat Associates, PC (NPI 1851377691)

Ear, Nose & Throat Associates, PC is a otolaryngology physician provider located in Fort Wayne, Indiana. 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	Ear, Nose & Throat Associates, PC
Address	10021 Dupont Circle Ct
City	Fort Wayne
State	IN
ZIP	46825
Taxonomy	Otolaryngology Physician
NPI Enumerated	December 22, 2005

Payer Source	Total Paid
Medicaid	$3.4M
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
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…	8,670	$90	$806.5K
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…	18,160	$40	$726.4K
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…	8,210	$60	$517.3K
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…	8,900	$60	$498.3K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	910	$190	$174.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,160	$140	$161.7K
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.	19,890	$10	$139.3K
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.	760	$120	$90.7K
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.	10,310	$10	$72.2K
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,…	1,730	$20	$39.7K

Showing 1–10 of 39

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Indiana Distribution

Ear, Nose & Throat Associates, PC — 3 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Indiana

Full comparison — all codes billed, vs. Indiana median

39 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…	317	2,120	870	$60	$450.6K
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…	223	2,380	920	$50	$376.8K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	3	30	60	$840	$335.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	6	60	150	$480	$221.3K
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.	11	40	400	$130	$116.1K
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…	18	790	150	$90	$99.4K
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…	33	890	160	$60	$76.8K
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,…	168	880	250	$40	$59.2K
99231	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a straightforward or low level of medical…	209	240	400	$20	$53.5K
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…	3	10	160	$130	$51.6K

Showing 1–10 of 39

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Francesca Blasio	FL	Audiologist	$60.9K	$0
Mohan Rao	IN	Otolaryngology Physician	$55.2K	$0
Douglas Nuckols	IN	Otolaryngology Physician	$52.3K	$0
Paul Porter	IN	Otolaryngology Physician	$47.6K	$0
Emily Bylett	IN	Physician Assistant	$44.2K	$0
Adam Kaiser	IN	Otolaryngology Physician	$43.9K	$0
Stephen Schreck	IN	Otolaryngology Physician	$37.9K	$0
Maria Ambush	IN	Family Nurse Practitioner	$27.7K	$0
Michele Parrish	IN	Speech-Language Pathologist	$24.5K	$0
Maryann Brock	NY	Audiologist	$13K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
A.i.d. Residential Services, LLC	IN	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$16.4M
Familia Dental Fort Wayne PLLC	IN	Dental Clinic/Center	$0	$8.7M
Lakewood Family Dental Inc	IN	Dentist	$0	$8.7M
Associated Surgeons And Physicians, LLC	IN	Obstetrics & Gynecology Physician	$0	$8.5M
Orthopaedics Northeast PC	IN	Orthopaedic Surgery Physician	$0	$6.6M
Hand In Hand Comprehensive Therapy Specialists Inc	IN	Occupational Therapist	$0	$6.4M
Kids.healthcare PC	IN	Pediatrics Physician	$0	$4.8M
Steppin Up Physical Therapy, Inc.	IN	Physical Therapist	$0	$4.6M
Mobile Medical Maintenance, LLC	IN	Durable Medical Equipment & Medical Supplies	$0	$4.3M
Dupont Hospital LLC	IN	General Acute Care Hospital	$0	$3.8M

Ear, Nose & Throat Associates, PC — Billing Profile & Reimbursement Data

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Ear, Nose & Throat Associates, PC — 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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