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

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

Mountainstar Medical Group-st. Marks Hospital, LLC (NPI 1073795258)

Field	Value
Entity Type	Organization
Organization	Mountainstar Medical Group-st. Marks Hospital, LLC
Address	348 E 4500 S Ste 300
City	Salt Lake City
State	UT
ZIP	84107
Taxonomy	Family Medicine Physician
NPI Enumerated	November 29, 2007

Payer Source	Total Paid
Medicaid	$734K
Medicare	$0

Medicaid: Complete Services Breakdown

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

8 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	7,630	$70	$518.6K
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…	4,120	$50	$197.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	150	$80	$11.5K
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…	50	$80	$4.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	140	$10	$1.1K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	90	$10	$700
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	10	$10	$90
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	110	$0	$0

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Utah Distribution

Mountainstar Medical Group-st. Marks Hospital, LLC — 1 of 7 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. Utah median

8 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…	50	1,340	200	$80	$144K
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…	111	1,360	190	$70	$125K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	110	200	240	$90	$85.8K
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…	159	270	80	$100	$41.6K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	295	610	140	$10	$13.8K
83036	Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).…	119	130	170	$10	$9.7K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	223	500	70	$10	$3.8K
G2211	Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care…	99	170	120	$1	$500

Related Providers

Other providers that share a Tax Identification Number (TIN) with Mountainstar Medical Group-st. Marks Hospital, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Richard Bennett	UT	Internal Medicine Physician	$320.7K	$0
Daniel Young	UT	Family Medicine Physician	$95.1K	$0
Preston Wilson	UT	Family Medicine Physician	$40.2K	$0
David Poor	IN	Family Medicine Physician	$34.5K	$0

Nearby Providers

Other providers in the same ZIP code as Mountainstar Medical Group-st. Marks Hospital, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$68.7M
Ihc Health Services, Inc.	UT	Clinical Medical Laboratory	$2.7M	$17.9M
Alpine Home Medical Equipment LLC	UT	Oxygen Equipment & Supplies (DME)	$0	$18.6M
Ddi Vantage	UT	Developmentally Disabled Services Day Training Agency	$0	$18.4M
Utah Emergency Physicians	UT	Emergency Medicine Physician	$0	$14.5M
Home Caregivers Partnership, LLC	UT	Home Health Agency	$0	$10.4M
Gcs Foundation	UT	Supports Brokerage Agency	$0	$6.2M
Ihc Health Services Inc	UT	Diagnostic Radiology Physician	$0	$6.1M
Joel Herring	UT	Retina Specialist (Ophthalmology) Physician	$5.6M	$23.7K
Project Reality	UT	Mental Health Counselor	$0	$5.1M

Mountainstar Medical Group-st. Marks Hospital, LLC — Billing Profile & Reimbursement Data

Sign up for Mountainstar Medical Group-st. Marks Hospital, LLC — Billing Profile & Reimbursement Data policy alerts

Mountainstar Medical Group-st. Marks Hospital, LLC — Billing Profile & Reimbursement Data

Sign up for Mountainstar Medical Group-st. Marks Hospital, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References