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

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

Valley Facial Plastics & Ent, PA (NPI 1952441024)

Field	Value
Entity Type	Organization
Organization	Valley Facial Plastics & Ent, PA
Address	330 Warner Dr
City	Lewiston
State	ID
ZIP	83501
Taxonomy	Otolaryngology Physician
NPI Enumerated	February 7, 2007

Payer Source	Total Paid
Medicaid	$378K
Medicare	$0

Medicaid: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,000	$110	$214.3K
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…	980	$70	$64.5K
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…	750	$70	$55K
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…	710	$60	$41.4K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	10	$140	$1.8K
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.	40	$20	$810
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.	30	$10	$210

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Idaho Distribution

Valley Facial Plastics & Ent, PA — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Idaho

Full comparison — all codes billed, vs. Idaho median

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	339	670	740	$40	$193.6K
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…	276	620	560	$60	$191.8K
69436	This procedure is a tympanostomy requiring the insertion of a ventilation tube under general anesthesia.	20	20	100	$450	$102.5K
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…	28	220	90	$80	$51.4K
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…	8	180	70	$110	$45.6K
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.	19	20	200	$10	$12.9K
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.	4	10	30	$20	$2K

Related Providers

Other providers that share a Tax Identification Number (TIN) with Valley Facial Plastics & Ent, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Jeffrey Burry	ID	Otolaryngology/Facial Plastic Surgery Physician	$137.5K	$0
Sennett Pierce Sr	ID	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	$96K	$0
Elizabeth O'neil	ID	Audiologist	$9.1K	$0
Maxine Miller	ID	Audiologist-Hearing Aid Fitter	$1.8K	$0

Nearby Providers

Other providers in the same ZIP code as Valley Facial Plastics & Ent, PA, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Alternative Nursing Services, Inc.	ID	Adult Day Care Clinic/Center	$0	$29.3M
Catalyst Medical Group, PLLC	ID	Multi-Specialty Clinic/Center	$0	$11.4M
Opportunities Unlimited, Inc.	ID	Specialist	$0	$9.1M
St. Joseph Hospital LLC	ID	General Acute Care Hospital	$0	$4.7M
County Of Nez Perce Independent School District No 1	ID	Local Education Agency (LEA)	$0	$3.5M
Community Health Association Of Spokane	ID	Federally Qualified Health Center (FQHC)	$0	$3.2M
City Of Lewiston	ID	Land Ambulance	$697.3K	$1.9M
Riverside Recovery LLC	ID	Addiction (Substance Use Disorder) Counselor	$0	$2.1M
Addus Healthcare (idaho), Inc	ID	In Home Supportive Care Agency	$0	$2M
Emeritus Properties Ii, Inc.	ID	Assisted Living Facility	$0	$1.9M

Valley Facial Plastics & Ent, PA — Billing Profile & Reimbursement Data

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Valley Facial Plastics & Ent, PA — 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