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

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

East Alabama Ear, Nose, & Throat, PC (NPI 1942228655)

East Alabama Ear, Nose, & Throat, PC is a otolaryngology physician provider located in Opelika, Alabama. This profile covers 0 Medicare and 23 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	East Alabama Ear, Nose, & Throat, PC
Address	1965 1st Ave
City	Opelika
State	AL
ZIP	36801
Taxonomy	Otolaryngology Physician
NPI Enumerated	July 18, 2006

Payer Source	Total Paid
Medicaid	$869.3K
Medicare	$0

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

23 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	6,910	$40	$241.7K
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.	10,110	$10	$131.4K
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…	1,050	$110	$117.4K
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.	770	$90	$72.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	810	$90	$71K
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…	870	$70	$58K
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…	480	$80	$36.6K
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…	1,160	$30	$36K
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…	250	$110	$28.4K
92557	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the softest level at which the patient can hear. He also measures the patient’s ability to…	1,080	$20	$22.6K

Showing 1–10 of 23

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Alabama Distribution

East Alabama Ear, Nose, & Throat, PC — 3 of 19 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Alabama

Full comparison — all codes billed, vs. Alabama median

23 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…	906	1,990	680	$60	$201.7K
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…	52	120	170	$160	$200.7K
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…	285	1,990	560	$40	$185.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	19	60	320	$130	$176.1K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	35	40	40	$380	$123.8K
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…	27	90	160	$100	$75.1K
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…	43	630	60	$80	$45.8K
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,…	150	500	120	$60	$42.2K
92552	The provider assesses a patient’s hearing with a series of tones at varying intensities to identify the lowest threshold at which the patient can hear.	23	20	140	$10	$33.1K
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…	243	660	80	$50	$26.8K

Showing 1–10 of 23

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Pediatric Clinic LLC	AL	Pediatrics Physician	$0	$24.9M
The East Alabama Health Care Authority	AL	General Acute Care Hospital	$0	$6.2M
Pediatric Associates Of Auburn	AL	Pediatric Adolescent Medicine Physician	$0	$4.2M
East Alabama Ems, LLC	AL	Ambulance	$1.1M	$2.6M
Eamc Er Physicians	AL	Emergency Medical Services (Emergency Medicine) Physician	$0	$2.6M
Gw Stone Capital LLC	AL	Optometrist	$0	$2.2M
Lee County Health Dept Fp Clinic	AL	Public Health or Welfare Agency	$0	$2M
Premier Ob/gyn, LLC	AL	Obstetrics & Gynecology Physician	$0	$1.9M
Eamc Physicians Group	AL	General Practice Physician	$0	$1.1M
Sunil Sharma	AL	Family Medicine Physician	$370.6K	$0

East Alabama Ear, Nose, & Throat, PC — Billing Profile & Reimbursement Data

Sign up for East Alabama Ear, Nose, & Throat, PC — Billing Profile & Reimbursement Data policy alerts

East Alabama Ear, Nose, & Throat, PC — Billing Profile & Reimbursement Data

Sign up for East Alabama Ear, Nose, & Throat, PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Warren Stiles	AL	Otolaryngology Physician	$107.4K	$0
Wesley Whatley	AL	Otolaryngology Physician	$97.9K	$0
William Blythe	AL	Otolaryngology Physician	$88.3K	$0
Meredith Blythe	AL	Family Nurse Practitioner	$33.9K	$0
Amy Nowlin	AL	Physician Assistant	$25.5K	$0
Constance Callen	AL	Nurse Practitioner	$23.7K	$0