Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidMartin Wareham
    Ask Trek AI about this page

    Martin Wareham — Billing Profile & Reimbursement Data

    NPI 1912914359 · Simi Valley, CA · Otolaryngology Physician

    Customize your policy alerts

    Sign up for Martin Wareham — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Martin Wareham is a otolaryngology physician provider located in Simi Valley, California. This profile covers 15 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationMartin Wareham
    Address2876 Sycamore Dr
    CitySimi Valley
    StateCA
    ZIP93065
    TaxonomyOtolaryngology Physician
    NPI EnumeratedAugust 1, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$209.8K
    Medicaid$0

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    15 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99213The 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…630$70$43.5K
    99203The 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…300$80$24.8K
    31231In this procedure, the provider inserts an endoscope into the nasal cavity to examine the structures of the nasal cavity on one or both sides.150$160$24.8K
    31575The 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.220$110$24K
    30801In this procedure, the provider uses methods like bipolar cautery, reducing the tissue volume, radiofrequency, or somnoplasty to ablate the superficial area of the inferior turbinates.130$180$22.2K
    99214The 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…220$100$22K
    69210The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.530$40$18.5K
    99204The 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…90$120$10.5K
    99202The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves straightforward medical decision making, and/or the provider…70$60$3.9K
    30901The provider uses a simple or limited approach to stop a nosebleed caused by a vessel in the front area of the nose.30$140$3.5K

    Showing 1–10 of 15

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 15 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    15 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    9921412,19937,970120$90$23.2K
    3123112354070$100$20.1K
    992132,34434,66080$70$13.2K
    3080111030$170$7.7K
    315752061050$100$7.3K
    992043,96919,36040$120$7.2K
    92511175020$100$5.2K
    9920321512,74030$80$4.6K
    69200546020$60$4.1K
    69210441,37030$30$4K

    Showing 1–10 of 15

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Martin Wareham, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    County Of VenturaCAGeneral Acute Care Hospital$0$136.1M
    County Of VenturaCAFederally Qualified Health Center (FQHC)$0$47.8M
    County Of VenturaCAFederally Qualified Health Center (FQHC)$0$32.4M
    Leo PolosajianCAClinical Cardiac Electrophysiology Physician$6M$1.6M
    Geoffrey TrenkleCAFacial Plastic Surgery Physician$517.4K$6.5M
    David BoyerCAOphthalmology Physician$5.6M$3.4K
    Homayoun TabandehCAOphthalmology Physician$5.1M$6.8K
    William PaceCANuclear Medicine Physician$4.1M$0
    Rajiv NagesettyCAVascular Surgery Physician$3.6M$0
    David KimCAOphthalmology Physician$3.5M$8.8K

    Nearby Providers

    Other providers in the same ZIP code as Martin Wareham, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Clinicas Del Camino Real IncCAFederally Qualified Health Center (FQHC)$0$26.4M
    Tony MakhloufCARheumatology Physician$2.6M$0
    Nika BagheriCARetina Specialist (Ophthalmology) Physician$1.7M$0
    Shahrzad ShareghiCACardiovascular Disease Physician$908.2K$0
    Sunset Sleep Labs LLCCAClinical Medical Laboratory$391.8K$446.3K
    Eugene AhnCARadiation Oncology Physician$643.9K$0
    Ashim AroraCAPulmonary Disease Physician$622.1K$0
    Samira MehriziCAFoot & Ankle Surgery Podiatrist$437.5K$83.6K
    Megha AgarwalCACardiovascular Disease Physician$377.1K$0
    Tung TangCANeurology Physician$374.7K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. California Distribution
    Martin Wareham — 4 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — California