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.

Scottsboro Ent, PC (NPI 1942368014)

Scottsboro Ent, PC is a otolaryngology physician provider located in Scottsboro, Alabama. This profile covers 0 Medicare and 15 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	Scottsboro Ent, PC
Address	406 Taylor St Ste B
City	Scottsboro
State	AL
ZIP	35768
Taxonomy	Otolaryngology Physician
NPI Enumerated	December 4, 2006

Payer Source	Total Paid
Medicaid	$1.2M
Medicare	$0

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

15 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
31020	In this procedure, the provider makes an intranasal incision. The provider then uses cutting forceps to perform a middle meatal sinusotomy.	1,630	$150	$248.2K
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.	2,220	$80	$166.1K
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…	3,690	$40	$158.6K
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…	4,030	$30	$133.1K
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…	1,720	$70	$115.2K
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…	1,330	$70	$98.7K
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.	15,370	$10	$92.2K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	1,160	$60	$69.7K
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…	650	$50	$34.5K
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.	3,300	$10	$33K

Showing 1–10 of 15

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

Scottsboro Ent, PC — 1 of 15 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

15 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…	405	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…	22	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…	414	1,990	560	$40	$185.6K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	15	60	320	$130	$176.1K
42830	The provider performs an initial adenoidectomy in a patient who is less than 12 years old.	3	10	60	$280	$144K
31020	In this procedure, the provider makes an intranasal incision. The provider then uses cutting forceps to perform a middle meatal sinusotomy.	1	10	930	$150	$141.6K
42820	The provider removes the tonsils and adenoids in a patient younger than 12 years old.	23	40	40	$380	$123.8K
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.	3	30	350	$100	$91.2K
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…	12	90	160	$100	$75.1K
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.	4	30	2,540	$10	$46.8K

Showing 1–10 of 15

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Kids 1st Pediatrics, LLC	AL	Pediatrics Physician	$0	$14.6M
Sunny Horizons, LLC	AL	Speech-Language Pathologist	$0	$7.3M
New Beacon Healthcare Group, LLC	AL	Community Based Hospice Care Agency	$0	$6.2M
American Drug Testing Lab LLC	AL	Clinical Medical Laboratory	$0	$5.4M
Scottsboro Pediatrics PC	AL	Primary Care Clinic/Center	$0	$4M
Northeast Alabama Health Services, Inc	AL	Federally Qualified Health Center (FQHC)	$0	$3.7M
Premier Medical Clinic LLC	AL	Multi-Specialty Clinic/Center	$0	$3.6M
Valley Medical Clinic LLC	AL	Rural Health Clinic/Center	$0	$1.6M
Hh Health System - Jackson LLC	AL	Land Ambulance	$934.4K	$406K
Adl Occupational Therapy, LLC	AL	Occupational Therapist	$0	$1.1M

Scottsboro Ent, PC — Billing Profile & Reimbursement Data

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Scottsboro Ent, 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

Related Providers

Nearby Providers

Frequently Asked Questions

References

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Darby Marshall	AL	Otolaryngology Physician	$129.9K	$0
Candace Amos	AL	Family Medicine Physician	$44.3K	$0