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

Why is the Medicaid comparison limited to Mississippi 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. Mississippi (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 Physicians Of North Miss., P.A. (NPI 1861507311)

Field	Value
Entity Type	Organization
Organization	Ear, Nose & Throat Physicians Of North Miss., P.A.
Address	618 Pegram Dr
City	Tupelo
State	MS
ZIP	38801
Taxonomy	Otolaryngology Physician
NPI Enumerated	August 21, 2006

Payer Source	Total Paid
Medicaid	$2.3M
Medicare	$0

Medicaid: Complete Services Breakdown

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

34 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…	21,140	$60	$1.2M
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…	4,210	$80	$349.3K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,140	$150	$173.7K
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…	3,430	$40	$130.2K
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…	2,170	$50	$108.7K
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…	690	$120	$85.1K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	940	$80	$76.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	270	$190	$51K
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.	5,630	$10	$50.6K
92504	In this diagnostic procedure, the provider uses a microscope to examine the ears of a patient. He may also sometimes examine the patient’s nose for direct visualization to help with diagnosis…	1,220	$20	$19.5K

Showing 1–10 of 34

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Mississippi Distribution

Ear, Nose & Throat Physicians Of North Miss., P.A. — 4 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Mississippi

Full comparison — all codes billed, vs. Mississippi median

34 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	8	30	70	$1,790	$891.2K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	11	50	300	$510	$483.3K
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…	520	1,910	930	$60	$278.7K
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.	23	20	400	$160	$231.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	320	340	4,380	$20	$210.2K
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…	41	1,670	720	$50	$196.4K
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…	10	30	260	$110	$191.3K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	355	370	4,870	$20	$189.2K
99243	The provider sees a patient for an office or other outpatient consultation involving evaluation and management (E/M). The E/M involves a low level of medical decision making or the provider spends at…	7	30	390	$70	$128.7K
97112	Neuromuscular reeducation is a therapeutic treatment (exercise) performed by a physician in an attempt to reduce impairments and restore function through the application of clinical skills and/or…	148	210	1,290	$20	$79.3K

Showing 1–10 of 34

Related Providers

Other providers that share a Tax Identification Number (TIN) with Ear, Nose & Throat Physicians Of North Miss., P.A., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Matthew Stevens	MS	Otolaryngology Physician	$231.4K	$1.5K
James Berry	MS	Otolaryngology Physician	$225.4K	$0
Robert Yarber	MS	Otolaryngology Physician	$199.3K	$2.7K
Kurt Nelson	MS	Otolaryngology Physician	$168.3K	$0
Ryan Simmons	MS	Otolaryngology Physician	$151.3K	$0
James Mcauley	MS	Otology & Neurotology Physician	$147.8K	$0
Alison Farley	MS	Physical Therapist	$115.2K	$0
Kacie Hollimon	MS	Family Nurse Practitioner	$74.8K	$0

Nearby Providers

Other providers in the same ZIP code as Ear, Nose & Throat Physicians Of North Miss., P.A., ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
North Mississippi Medical Center, Inc.	MS	General Acute Care Hospital	$0	$117.7M
North Mississippi Medical Clinics Inc	MS	Internal Medicine Physician	$0	$16.9M
Happy Smiles Dentistry - Tupelo LLC	MS	General Practice Dentistry	$0	$16.2M
North Mississippi Ambulatory Surgery Center LLC	MS	Ambulatory Surgical Clinic/Center	$1.5M	$7.1M
Relias Emergency Medicine Specialists Of Tupelo LLC	MS	Emergency Medicine Physician	$0	$8.4M
Sog Surgery Center LLC	MS	Ambulatory Surgical Clinic/Center	$7.5M	$480
Prescribed Pediatric Extended Care, Inc	MS	Medically Fragile Infants and Children Day Care	$0	$7.2M
Kare-in-home Hospice Of North Mississippi, LLC	MS	Community Based Hospice Care Agency	$0	$5M
North Mississippi Allergy And Asthma Center PLLC	MS	Allergy & Immunology Physician	$0	$4.3M
Sanders Clinic For Women PA	MS	Obstetrics & Gynecology Physician	$0	$3.8M

Ear, Nose & Throat Physicians Of North Miss., P.A. — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

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Frequently Asked Questions

References