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 & MedicaidJames Newlon
    Ask Trek AI about this page

    James Newlon — Billing Profile & Reimbursement Data

    NPI 1982785937 · Fort Myers, FL · Otolaryngology Physician

    Customize your policy alerts

    Sign up for James Newlon — 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.

    James Newlon is a otolaryngology physician provider located in Fort Myers, Florida. 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
    OrganizationJames Newlon
    Address9711 Commerce Center Ct
    CityFort Myers
    StateFL
    ZIP33908
    TaxonomyOtolaryngology Physician
    NPI EnumeratedOctober 18, 2006

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

    Payer SourceTotal Paid
    Medicare$270.6K
    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
    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…1,030$90$96.3K
    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.480$150$72K
    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…270$120$32.1K
    31253The provider performs a complete excision of the ethmoid air cells (anterior and posterior) with exploration of the frontal sinus; he may or may not remove tissue from frontal sinus. The procedure is…20$600$11.4K
    69210The provider uses an instrument such as a curette, vacuum evacuation, or forceps to remove entrapped wax from a patient's external auditory canal.340$30$11.4K
    31237In this procedure, the provider inserts an endoscope into the nasal cavity. She examines the nasal contents. The provider then performs a nasal biopsy, polypectomy, or debridement.40$300$11.2K
    30520Septoplasty is most often performed for a deviated septum which can be either C–shaped, S–shaped, or a cartilaginous deviation.20$460$9.6K
    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.60$100$5.6K
    31267In this procedure, the provider inserts an endoscope into the nasal cavity. She then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus…20$230$5K
    31238In this procedure, the provider inserts an endoscope into the nasal cavity. The provider then uses bipolar cautery or other means to control bleeding.20$210$4.4K

    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
    992141,77132,760140$90$25K
    312313752090$140$24.5K
    31267154020$750$15.7K
    312375612030$270$13.1K
    30520156020$490$8.9K
    3125311020$580$8.7K
    3157529457060$90$8.6K
    30140327020$270$7.5K
    9920438419,04040$110$7K
    31238196020$210$4.9K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Drew HorlbeckFLOtology & Neurotology Physician$239K$0
    Douglas StevensFLOtolaryngology/Facial Plastic Surgery Physician$118.9K$0
    Brooke PapeFLAudiologist$32.1K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Lee Memorial Health SystemFLInternal Medicine Physician$0$15.1M
    Hope Hospice And Community Services IncFLCommunity Based Hospice Care Agency$0$12.9M
    Lee Memorial Health SystemFLMedically Fragile Infants and Children Day Care$0$7.4M
    Syed ZafarFLMedical Oncology Physician$6M$0
    Veronica PapaveroFLAnatomic Pathology Physician$3.7M$0
    Raymond EsperFLMedical Oncology Physician$3M$0
    Francisco RodriguezFLMedical Oncology Physician$2.7M$0
    Alan BrownFLRadiation Oncology Physician$2.2M$0
    Keith MillerFLRadiation Oncology Physician$1.7M$0
    William HarwinFLMedical Oncology Physician$1.5M$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. Florida Distribution
    James Newlon — 1 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Florida