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.

Ivy Lane Pediatrics, LLC (NPI 1083635692)

Field	Value
Entity Type	Organization
Organization	Ivy Lane Pediatrics, LLC
Address	5974 Fashion Point Dr Ste 230
City	South Ogden
State	UT
ZIP	84403
Taxonomy	Home Health Agency
NPI Enumerated	July 21, 2006

Payer Source	Total Paid
Medicaid	$37M
Medicare	$0

Key Findings

This provider is effectively a Medicaid-focused home health operation: there is no Medicare billing on file and the lifetime Medicaid revenue is $37M, indicating a single-payer (Medicaid) revenue profile rather than a dual Medicare/Medicaid practice mix. Analysts should treat Medicaid as the sole material payer for revenue and utilization analysis.

Revenue is extremely concentrated in a narrow set of home-health service codes: the top three Medicaid codes — T1000, T1005, and T1001 — account for 98.6% of the provider's total Medicaid revenue. T1000 alone represents $28.6M (77.2% of Medicaid revenue), T1005 contributes $6.4M (17.3%), and T1001 adds $1.5M (4.1%), leaving only a small remainder for other codes.

The code-level activity and rates indicate a business model focused on private-duty nursing and respite care in the home: T1000 (82K claims, $349 avg paid/claim) is the dominant revenue driver and T1005 (40.1K claims, $160 avg paid/claim) is the principal secondary service, while T1001 (1.8K claims, $847 avg paid/claim) reflects nursing assessments. Together these patterns are consistent with a home health agency operating high-volume private-duty/independent nursing and respite programs rather than episodic skilled home health care.

Competitive standing in-state is strong for the primary services: the provider ranks #1 of 7 for T1000 and #1 of 9 for T1005, both at the 100th percentile and described as notably above typical state volume. These rankings identify the provider as a dominant supplier of private duty nursing and respite services within Utah’s measured market for those codes.

For ancillary or less-revenue-driving codes the provider is a modest participant: T1001 ranks #22 of 65 (67th percentile) and T1021 ranks #22 of 41 (48th percentile), while other codes (S9122, T1019, S9129) report low revenue shares and middle-to-low state rank positions. This suggests the operation concentrates capacity on a few high-volume services rather than a broad mix of home health or therapy offerings.

The provider’s long tenure supports an established local presence: its NPI was enumerated on 2006-07-21 (~20 years ago), which aligns with sustained Medicaid billing history and may reflect developed payer relationships and patient referral streams in SOUTH OGDEN, UT.

High dependence on a small set of service lines creates operational and reimbursement exposure: with T1000 and T1005 combining to drive the vast majority of the $37M Medicaid revenue, any changes in utilization patterns, eligibility rules, or reimbursement for private duty nursing and respite care could materially affect the provider’s revenue. Analysts should flag concentration risk when modeling future revenue scenarios.

Although the provider dominates the state market for its top two codes, overall market depth appears limited (e.g., only 7 providers report T1000 statewide), indicating that the provider’s leading position exists within a small competitive set; this concentration suggests strong local market share but also limited scale relative to larger regional or national home-health operators.

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
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	81,960	$350	$28.6M
T1005	Respite care services, up to 15 minutes	40,070	$160	$6.4M
T1001	Nursing assessment / evaluation	1,780	$850	$1.5M
T1021	Home health aide or certified nurse assistant, per visit	9,270	$50	$454.2K
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	950	$60	$54.3K
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	610	$30	$15.8K
S9129	Occupational therapy, in the home, per diem	40	$90	$3.3K

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

Ivy Lane Pediatrics, LLC — 2 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

7 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1000	Private duty / independent nursing service(s) - licensed, up to 15 minutes	1	10	25,500	$350	$11.1M
T1021	Home health aide or certified nurse assistant, per visit	22	40	10,290	$60	$1.7M
S9122	Home health aide or certified nurse assistant, providing care in the home; per hour	9	10	5,040	$80	$1.7M
T1005	Respite care services, up to 15 minutes	1	10	3,930	$150	$1.7M
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	27	30	6,130	$110	$1.1M
T1001	Nursing assessment / evaluation	22	70	700	$80	$603.4K
S9129	Occupational therapy, in the home, per diem	3	10	900	$80	$306.4K

Nearby Providers

Other providers in the same ZIP code as Ivy Lane Pediatrics, 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	$54.1M
Ogden Clinic PC	UT	Family Medicine Physician	$0	$8.3M
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$5.1M
Utah Hematology Oncology PC	UT	Hematology & Oncology Physician	$0	$4.6M
Mt Ogden Utah Surgical Center LLC	UT	Ambulatory Surgical Clinic/Center	$1.2M	$1.3M
South Ogden Operations, LLC	UT	Assisted Living Facility	$0	$2.4M
Lisa Leishman	UT	Ophthalmology Physician	$1.6M	$419.9K
Sutton Clinical Services LLC	UT	Mental Health Counselor	$0	$1.8M
Ogden Clinic Specialty Services LLC	UT	Sports Medicine (Family Medicine) Physician	$0	$1.7M
Alpine Home Medical Equipment LLC	UT	Oxygen Equipment & Supplies (DME)	$0	$1.6M

Ivy Lane Pediatrics, LLC — Billing Profile & Reimbursement Data

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Ivy Lane Pediatrics, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References