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.

Revere Health PC (NPI 1093764805)

Key Findings

Field	Value
Entity Type	Organization
Organization	Revere Health PC
Address	1055 N 500 W
City	Provo
State	UT
ZIP	84604
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 9, 2006

Payer Source	Total Paid
Medicaid	$24M
Medicare	$0

REVERE HEALTH PC has no Medicare billing on file and is effectively a single-payer (Medicaid) outpatient-focused organization at scale; lifetime Medicare revenue is reported as none while total Medicaid revenue is $24M, indicating Medicaid is the primary revenue source captured in these datasets. This concentration implies any payer strategy or contract negotiation for this entity should prioritize Medicaid relationships and utilization patterns.

Revenue concentration within Medicaid is highly concentrated: the top three Medicaid codes by revenue account for 73.2% of the provider’s total Medicaid revenue, with 99214 ($8.3M, 40.8%) and 99213 ($5.7M, 28.2%) dominating the mix and 99232 contributing $855.2K (4.2%). This indicates the bulk of billing comes from office/outpatient E/M visits and a smaller but material share from subsequent inpatient/observation care.

The procedure and service mix signals a multi-specialty outpatient clinic with substantial primary and follow-up visit volume. High volumes for 99214 and 99213 (combined >250K claims) reflect heavy reliance on established-patient office visits, while notable volumes in 99203 and 99204 (new patient outpatient E/M codes) indicate ongoing patient intake and ambulatory care growth. Ancillary services such as chemotherapy (96413), obstetrical global delivery care (59400), imaging (74177), and various endoscopy codes (43239, 43235, 45385) show the practice supports multiple service lines beyond general outpatient visits.

State competitive standing is exceptionally strong for core outpatient E/M codes: 99213 ranks #1 of 1355 providers in-state and 99214 ranks #2 of 1340 providers in-state, both at the 100th percentile and called out as extreme outliers. Several other codes (99203, 99204, 99231, 36415, 90471) also rank at or near the top statewide, indicating REVERE HEALTH PC is a dominant volume provider in Utah for routine outpatient visits, basic labs, and vaccinations.

For some hospital-based E/M and procedural codes the provider shows high but more typical in-state volume: 99232 ranks #2 of 96 providers (99th percentile, extreme outlier) and 99233 ranks #7 of 91 providers (93rd percentile, described as typical), suggesting strong inpatient/observation follow-up activity but with more variability across levels of care. Chemotherapy (96413) and several imaging/pathology codes are described as typical or unremarkable in percentile rank, meaning these ancillary lines contribute materially to revenue without making REVERE an outlier in those niches.

The provider has long-tenure in the NPI registry: NPI enumerated on 2006-05-09 (approximately 20 years ago), which supports interpretation of established operations and sustained Medicaid relationships over time. This longevity combined with the dominant in-state rankings for key outpatient codes suggests entrenched referral patterns and patient panels.

The revenue mix shows both high-frequency, low-price services and lower-frequency, higher-price procedures: high claim counts for 99214 (133.1K claims at $62 avg paid/claim) and 99213 (116.3K claims at $49 avg paid/claim) drive most revenue, while services like 96413 (1.1K claims at $755 avg) and 59400 (232 claims at $1604 avg) provide supplementary higher-dollar contributions. This dual pattern indicates operational capacity to manage large volumes of routine visits while also delivering episodic higher-acuity or procedure-based care.

Given the absence of Medicare billing on file, payer-mix risk should be considered: REVERE HEALTH PC’s financial exposure in this dataset is concentrated in Medicaid flows only, so any Medicaid policy or rate changes would disproportionately affect reported revenue. For competitive benchmarking, analysts should treat Medicare-based comparisons as not applicable and focus on in-state Medicaid peer analysis where REVERE is often an extreme outlier in outpatient E/M volumes.

Medicaid: Complete Services Breakdown

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

355 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…	133,130	$60	$8.3M
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…	116,290	$50	$5.7M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	23,760	$40	$855.2K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	1,120	$760	$842.6K
99203	The 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…	11,110	$60	$666.8K
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…	6,630	$90	$570.3K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	230	$1,600	$372.1K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	5,880	$50	$305.9K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	9,080	$30	$245.1K
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…	3,210	$70	$234.3K

Showing 1–10 of 355

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

Revere Health PC — 10 of 25 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

355 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	249	370	690	$140	$704.2K
90834	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	43	110	270	$120	$439.4K
J0585	Injection, onabotulinumtoxina, 1 unit	4	10	200	$470	$355.6K
A9552	Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries	6	10	60	$740	$253.1K
90832	In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…	85	90	270	$70	$200.4K
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	25	120	1,100	$30	$186.6K
78431	The provider performs a PET myocardial imaging scan, a type of nuclear imaging test, with CT transmission scan that reveals blood flow to and from the heart (perfusion). Ejection fraction and…	6	10	200	$590	$185.9K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	1	10	60	$1,680	$152.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	5	240	220	$50	$145.2K
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…	2	1,340	200	$80	$144K

Showing 1–10 of 355

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joseph Te	UT	Hematology & Oncology Physician	$1.6M	$0
Brandt Esplin	UT	Hematology & Oncology Physician	$1.1M	$0
Jamison Jones	UT	Cardiovascular Disease Physician	$1M	$0
Steven Wallentine	UT	Hematology & Oncology Physician	$1M	$7.6K
Robert Dowse	UT	Pediatrics Physician	$0	$867K
David Slade	UT	Ophthalmology Physician	$651.1K	$0
Marc Nuttall	UT	Hematology & Oncology Physician	$549.1K	$580
Leslee Adams	UT	Family Nurse Practitioner	$513.4K	$0
David Cragun	UT	Cardiovascular Disease Physician	$465.1K	$940
James Macdonald	UT	Dermatology Physician	$415.3K	$26.5K

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Utah Valley Pediatrics L.L.C.	UT	Pediatrics Physician	$0	$11.9M
Riverwoods Surgery Center, LLC	UT	Ambulatory Surgical Clinic/Center	$737.9K	$5M
Utah Valley Emergency Physicians Inc	UT	Emergency Medicine Physician	$0	$4.7M
Ryan Isom	UT	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Jack Stringham	UT	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$3.3M
Richard Corey	UT	Retina Specialist (Ophthalmology) Physician	$3M	$50.1K
Provo City Board Of Education	UT	Local Education Agency (LEA)	$0	$3M
Robert Welch	UT	Retina Specialist (Ophthalmology) Physician	$2.5M	$0

Revere Health PC — 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

Related Providers

Nearby Providers

Frequently Asked Questions

References