Southwest Ear, Nose & Throat, PLLC

Southwest Ear, Nose & Throat, PLLC was paid $498K by Medicaid between May 2020 and Oct 2024, across 18 billing codes. Its largest line is 31231, — 30% of everything it billed.

33Billing provider infoSOUTHWEST EAR, NOSE & THROAT, PLLC
LAKE HAVASU CITY, AZ 86403

33aNPI1861020703assigned 03/27/2020

33bProvider typeOtolaryngology Physician

28Total paid$498K

24GClaims6,901

24DCodes billed18

24AFirst – last monthMay 2020 – Oct 2024

Compared with peers

Next to other Otolaryngology Physician providers in Arizona

Rank by total paid#10 of 35

Median peer was paid$65K

This provider vs. median7.6×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2020	1,215	$56K
2021	1,658	$113K
2022	1,521	$126K
2023	1,522	$123K
2024incomplete	985	$81K

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
31231		30%	830	794	$151K
99213	Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity	22%	1,892	1,812	$109K
99203	Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity	17%	1,141	1,108	$86K
99214	Doctor's office visit, returning patient (more involved)Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity	15%	942	883	$73K
99204	Doctor's office visit, new patient (more involved)Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity	7.7%	324	312	$39K
76536		6.3%	749	736	$31K
31575		1.3%	67	65	$7K
92567		<1%	117	116	$2K
92504		<1%	18	12	$501.63
92557		<1%	13	12	$405.96
92587		<1%	12	12	$333.84
G9903	Patient screened for tobacco use and identified as a tobacco non-user	0%	189	136	$0.00

6 more codes

1036F		0%	133	$0.00
G8420	Bmi is documented within normal parameters and no follow-up plan is required	0%	154	$0.00
G9969	Clinician who referred the patient to another clinician received a report from the clinician to whom the patient was referred	0%	66	$0.00
G8484	Influenza immunization was not administered, reason not given	0%	225	$0.00
G8417	Bmi is documented above normal parameters and a follow-up plan is documented	0%	15	$0.00
G9968	Patient was referred to another clinician or specialist during the measurement period	0%	14	$0.00

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialPRATER, MICHAEL (OWNER / MEMBER MANAGER)