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NPI 1144497322 · Provo, UT · Hematology & Oncology Physician
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Marc Nuttall is a hematology & oncology physician provider located in Provo, Utah. This profile covers 43 Medicare and 3 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Marc Nuttall |
| Address | 1055 N 500 W Ste 202 |
| City | Provo |
| State | UT |
| ZIP | 84604 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | May 15, 2008 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $549.1K |
| Medicaid | $580 |
This provider is effectively single‑payer in scale: reported Medicare revenue is $549.1K while Medicaid revenue is $580, so Medicare is the dominant source of billing and Medicaid activity is negligible by comparison. The Medicaid total is immaterial relative to Medicare, indicating the practice either does not contract broadly with Medicaid or bills very little to that payer.
Medicare revenue is highly concentrated: the top three Medicare codes (J0897 38.3%, J3380 20.9%, 99214 7.8%) collectively account for 67.0% of this provider's total Medicare revenue. That concentration points to a small set of high-impact services driving the practice's Medicare economics rather than a broad, diversified code mix.
On the Medicare side the code mix points to a biologics/infusion-oriented practice with outpatient E/M activity: large volumes of injectable biologics J0897 (11.5K claims) and J3380 (7.5K claims) sit alongside chemotherapy administration codes such as 96413 (195 claims) and infusion encounter codes like 96365 and 96367, plus E/M visits (99214). Together these items are consistent with a clinic that delivers frequent infused or injected biologic therapies and performs office-based oncology/hematology visits.
Code-level competitive standing is mixed. J0897 drives the largest share of Medicare revenue and ranks #901 of 10057 providers nationally (91th percentile) but is described in the dataset as "typical, unremarkable volume for this code," J3380 is mid‑range nationally (#330 of 620; 47th percentile) and also labeled "typical, unremarkable volume," while J3111 appears low relative to its national peer group (#905 of 970; 6th percentile) despite the same descriptive label. These rank/label combinations suggest the provider is a meaningful national participant for a small set of biologics but not an outlier monopolist.
Medicaid billing is entirely concentrated in basic lab and specimen codes: the top three Medicaid codes (80053 67.1%, 85025 24.0%, 36415 8.9%) account for 100.0% of Medicaid revenue. Medicaid volumes are low in-state: 80053 ranks #99 of 104 providers in-state (5th percentile) and 85025 ranks #113 of 121 (7th percentile), indicating the provider is a minor Medicaid participant for those services compared with local peers.
Operational implications from the claims and paid amounts: the practice reports very high claim counts for certain biologics with relatively low average paid/claim (for example J0897 11.5K claims at $18 avg paid/claim and J3380 7.5K claims at $15 avg paid/claim), which indicates throughput-driven revenue from high-volume, lower-dollar-per-unit injectable administrations rather than reliance on a small number of high-dollar infusions. This pattern suggests scheduling, infusion capacity, and inventory management for disposable biologics are likely central operational considerations.
Clinical mix includes both direct cancer therapy and supportive care: chemotherapy administration codes (96413, 96401, 96402) are present alongside supportive or related injectables such as J0885 (epoetin alfa), J1439 (ferric carboxymaltose), and J9217 (leuprolide), indicating the practice provides both anti‑neoplastic therapy and treatments for anemia or other therapy‑related conditions. The mix reinforces a specialty profile aligned with Hematology & Oncology taxonomy rather than a pure primary‑care or procedural office.
Provider tenure is well established: the NPI was enumerated 2008-05-15 (~18 years ago), indicating roughly two decades of enrollment which, combined with the Medicare revenue scale, points to an established practice footprint; however, the extremely small Medicaid footprint suggests limited engagement with that payer despite long tenure.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
43 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0897 | Injection, denosumab, 1 mg | 11,460 | $20 | $206.3K |
| J3380 | Injection, vedolizumab, intravenous, 1 mg | 7,510 | $20 | $112.6K |
| 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… | 470 | $90 | $41.7K |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 4,830 | $10 | $38.6K |
| J0885 | Injection, epoetin alfa, (for non-esrd use), 1000 units | 3,240 | $10 | $19.4K |
| 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… | 200 | $100 | $18.5K |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 18,000 | $1 | $18K |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 120 | $130 | $15.3K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 210 | $40 | $9.2K |
| 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… | 930 | $10 | $7.4K |
Showing 1–10 of 43
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 43 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
43 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J3111 | 6 | 10 | 9,770 | $10 | $149.8K |
| J3380 | 4 | 10 | 9,900 | $20 | $140.4K |
| J0897 | 5 | 70 | 1,920 | $20 | $67.2K |
| J9217 | 17 | 30 | 140 | $130 | $23.8K |
| J0885 | 1 | 10 | 3,240 | $10 | $19.7K |
| J1439 | 6 | 20 | 15,750 | $1 | $17.5K |
| 96413 | 11 | 50 | 100 | $90 | $13.8K |
| 96401 | 10 | 20 | 140 | $50 | $13.7K |
| 99214 | 244 | 4,080 | 80 | $80 | $11.6K |
| 99215 | 777 | 1,190 | 40 | $110 | $7.5K |
Showing 1–10 of 43
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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. | 20 | $20 | $390 |
| 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… | 20 | $10 | $140 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 10 | $1 | $50 |
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 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… | 113 | 120 | 1,100 | $30 | $186.6K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 226 | 240 | 220 | $50 | $145.2K |
| 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. | 99 | 100 | 2,770 | $10 | $75.1K |
Other providers in the same ZIP code as Marc Nuttall, ranked by combined Medicare and Medicaid revenue.
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