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    v1.0.28
    OpenPayerNPI Medicare & MedicaidJames Spires
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    James Spires — Billing Profile & Reimbursement Data

    NPI 1992799571 · Mobile, AL · Otolaryngology Physician

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    James Spires is a otolaryngology physician provider located in Mobile, Alabama. 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.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Spires
    Address3701 Dauphin St
    CityMobile
    StateAL
    ZIP36608
    TaxonomyOtolaryngology Physician
    NPI EnumeratedSeptember 9, 2005

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

    Payer SourceTotal Paid
    Medicare$185.4K
    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
    31298The provider passes an endoscope into the nasal cavity of the patient through which he passes a balloon–tipped catheter and dilates the ostium (opening) of the frontal and sphenoid sinuses.30$3,360$87.5K
    31295The provider passes an endoscope into the nasal cavity of the patient. He also dilates the ostium, or opening, of the maxillary sinus. The approach is either through the nose or via a depression on…30$1,580$41.2K
    95165In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.1,990$10$19.9K
    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…140$60$8K
    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…80$60$5K
    77011In this procedure, the provider uses computed tomography guidance to locate small targets inside the body using a three–dimensional coordinate system.40$110$4.6K
    95004The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.1,280$1$3.8K
    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.40$80$3.2K
    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$50$3.2K
    99212The 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,…90$40$3.2K

    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
    3129831020$3,380$74.3K
    3129531020$1,560$37.5K
    95165970860$10$13K
    992131,9746,47080$50$7.9K
    315757812050$80$4.8K
    7701141030$130$4.3K
    992033452,21030$70$3.1K
    950041240790$1$2.9K
    9255712418070$20$2.4K
    992122101,24030$30$2.1K

    Showing 1–10 of 15

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Premier Health Management, Inc.ALOphthalmology Physician$0$3M
    Mark DouglasALOphthalmology Physician$2.1M$0
    Henry SempleALOphthalmology Physician$2M$0
    Stuart BallALOphthalmology Physician$1.3M$0
    Mark GacekALOtolaryngology Physician$244.7K$0
    Curtis GrafALOphthalmology Physician$242.9K$0
    Ryan BurtonALOphthalmology Physician$240.4K$0
    Joseph TurnerALOphthalmology Physician$239.7K$0
    Jay BrownALOphthalmology Physician$211.9K$0
    Charles SalisburyALOphthalmology Physician$199.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Children's Medical Group, P.A.ALSpecialist$0$7.4M
    Coast Diagnostics, LLCALClinical Medical Laboratory$275.1K$5.7M
    Springhill Hospitals, IncALGeneral Acute Care Hospital$0$5.3M
    Pulmonary Associates Of Mobile PCALPulmonary Disease Physician$0$5.3M
    Providence HospitalALGeneral Acute Care Hospital$0$4.8M
    Alabama Providence Healthcare ServicesALInternal Medicine Physician$0$4.7M
    University Of South Alabama Health Care AuthorityALInternal Medicine Physician$0$3.9M
    Mobile Emergency Physicians, LLCALEmergency Medicine Physician$0$3.3M
    Imc-pediatric & Adolescent Medicine, LLCALPediatric Adolescent Medicine Physician$0$3.3M
    Springhill Emergency Physicians, PCALEmergency Medicine Physician$0$3.2M

    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. Alabama Distribution
    James Spires — 0 of 15 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Alabama