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 District of Columbia for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to District of Columbia 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. District of Columbia (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.

Scott Mcnamara (NPI 1861462467)

Scott Mcnamara is a otolaryngology physician provider located in Washington, District of Columbia. This profile covers 13 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Provider details (source: NPPES NPI Registry)

Medicare: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Scott Mcnamara
Address	4910 Massachusetts Ave Nw
City	Washington
State	DC
ZIP	20016
Taxonomy	Otolaryngology Physician
NPI Enumerated	January 25, 2006

Payer Source	Total Paid
Medicare	$53.7K
Medicaid	$0

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

13 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…	160	$100	$16.9K
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…	100	$130	$12.5K
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…	110	$70	$8.1K
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.	90	$40	$3.4K
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.	10	$180	$2.3K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	10	$160	$2.2K
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.	20	$120	$2.1K
31505	The provider uses a laryngeal mirror to look inside the larynx (voice box) to detect any abnormalities. This code represents a diagnostic procedure.	20	$80	$1.4K
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…	20	$80	$1.4K
92511	The provider examines the nasal passages and throat with an endoscope, a tubular instrument with a light source and camera.	10	$110	$1.3K

Showing 1–10 of 13

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
31231	17	20	30	$170	$22K
99214	414	1,400	90	$100	$15.3K
99215	589	660	50	$130	$12.3K
99213	368	1,200	50	$70	$8.5K
99204	88	670	30	$130	$6.4K
31575	20	20	50	$100	$6.4K
97140	130	140	220	$20	$5.9K
92504	10	10	120	$20	$4.4K
99203	295	430	30	$80	$3.8K
99212	205	240	30	$40	$2.8K

Scott Mcnamara — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Frequently Asked Questions

References