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.

Tooele Hospital Corporation (NPI 1124090659)

Field	Value
Entity Type	Organization
Organization	Tooele Hospital Corporation
Address	2055 N Main St
City	Tooele
State	UT
ZIP	84074
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 7, 2006

Payer Source	Total Paid
Medicaid	$11.6M
Medicare	$0

Key Findings

TOOELE HOSPITAL CORPORATION reports no Medicare billing on file and $11.6M in lifetime Medicaid revenue, making its publicly visible billing footprint effectively single‑payer Medicaid rather than a mixed Medicare/Medicaid profile. Analysts should treat Medicaid as the primary source of claims and revenue when profiling this entity.

Revenue is highly concentrated: the precomputed top-three Medicaid codes account for 83.7% of the provider’s total Medicaid revenue, with code 8888888 alone representing $8.8M (78.0% of Medicaid revenue). This concentration indicates most Medicaid receipts derive from a single dominant code rather than a broadly diversified set of services.

The top supporting codes point to a lab- and specimen-focused operation: 80053 (comprehensive metabolic panel) produced $348.6K (3.1%) across 12K claims and 36415 (venipuncture) produced $304.1K (2.7%) across 4.5K claims. Along with other lab CPTs in the list (83605, 84484, 80306, 87635, 0225U), the code mix suggests the hospital runs a high-volume clinical laboratory and specimen-collection workflow that drives much of its Medicaid revenue.

Competitive standing is mixed by service: for the dominant code 8888888 the provider ranks #11 of 57 in-state (82th percentile; typical, unremarkable volume for this code), indicating a sizable but not dominant statewide share for that source. By contrast, the provider ranks #1 of 15 for 80306 (100th percentile; extreme outlier), showing it is the state leader in instrument-read presumptive drug testing volume and significantly above typical peer activity for that specific test.

Emergency department activity appears substantial in volume but low in Medicaid reimbursement per visit: 99284 has 10.1K claims at $20 avg paid/claim ($202.9K revenue, 1.8% of Medicaid revenue) and 99283 has 6.5K claims at $36 avg paid/claim ($232.8K, 2.1%). These patterns are consistent with a hospital providing appreciable ED throughput for Medicaid patients where per-claim payments are relatively modest.

The provider offers some specialized and unique lab services: 0225U (a PLA code) shows 494 claims at $78 avg paid/claim ($38.5K revenue) and is listed as #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), indicating at least one proprietary test in its portfolio. C9803 and 87635 reflect COVID-19 related outpatient testing activity but contribute smaller shares of total Medicaid revenue.

Payment-per-claim dispersion is wide across the Medicaid mix, from higher-paid items like 8888888 ($213 avg paid/claim) and C9803 ($94 avg paid/claim) to very low-paid, high-frequency services such as 81001 ($3 avg paid/claim) and 99285 ($7 avg paid/claim). This suggests the hospital’s overall Medicaid revenue profile is driven by a small number of high‑average‑paid lab codes while many clinical services produce limited revenue per encounter.

The provider has long-tenured enrollment in public programs: its NPI was enumerated on 2006-02-07 (~20 years ago), indicating two decades of participation in payer networks and likely established operational capacity to support its lab and emergency service lines.

Medicaid: Complete Services Breakdown

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

126 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
8888888	N/A	41,530	$210	$8.8M
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	12,020	$30	$348.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	4,470	$70	$304.1K
83605	The lab analyst measures the lactate, most often in a blood or plasma sample. Lactate, also known as lactic acid, is the end product of anaerobic carbohydrate metabolism produced primarily by muscle…	3,780	$80	$283.2K
84484	The lab analyst performs the technical lab test typically using serum, plasma, or whole blood to quantitate troponin. Troponin is a protein labs commonly measure to verify a myocardial infarction and…	3,540	$80	$279.9K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	6,470	$40	$232.8K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	10,150	$20	$202.9K
80306	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by instrument–assisted direct optical observation, often utilizing immunoassay, to screen for any number of…	2,270	$60	$131.7K
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	1,260	$90	$118.3K
86850	The lab analyst performs a screening test using patient blood to determine the presence of any antibodies to red blood cells, called RBCs, other than the A and B antigens.	900	$100	$85.9K

Showing 1–10 of 126

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

Tooele Hospital Corporation — 1 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

126 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
8888888	N/A	11	60	8,900	$400	$9.5M
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	5	10	2,100	$90	$1.1M
U0003	Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…	11	20	270	$40	$334.7K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	29	160	190	$70	$283.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	22	190	200	$50	$239.5K
G0480	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	28	40	770	$90	$231.9K
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…	16	120	1,100	$30	$186.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	21	50	4,040	$30	$186.4K
J0690	Injection, cefazolin sodium, 500 mg	21	30	960	$90	$162.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	25	190	250	$40	$146.8K

Showing 1–10 of 126

Nearby Providers

Other providers in the same ZIP code as Tooele Hospital Corporation, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Skull Valley Health Care	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$25.8M
Nat-su Behavioral Health LLC	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.3M
Skull Valley Health Clinic	UT	Clinic/Center	$0	$4.5M
Ambulance Services Of Tooele, LLC	UT	Land Ambulance	$372.1K	$3.4M
Goshute Health Care LLC	UT	Clinic/Center	$0	$2.9M
Patrick Green Md PLLC	UT	Primary Care Clinic/Center	$0	$1.8M
Tooele County School District	UT	Local Education Agency (LEA)	$0	$1.4M
Tooele Clinic Corp	UT	Family Medicine Physician	$0	$1.3M
Jim J. Gould, Md PC	UT	Clinic/Center	$0	$1.2M
Nat-su Health Care LLC	UT	Clinic/Center	$0	$1.1M

Tooele Hospital Corporation — 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