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.

Michael Grant (NPI 1154851467)

Field	Value
Entity Type	Individual
Organization	Michael Grant
Address	2891 E Mall Dr Ste 101
City	St George
State	UT
ZIP	84790
Taxonomy	Rheumatology Physician
NPI Enumerated	June 19, 2017

Payer Source	Total Paid
Medicare	$2.1M
Medicaid	$0

Key Findings

This provider’s Medicare activity is overwhelmingly driven by in-office administration of biologic and infusion therapies consistent with a rheumatology infusion practice: the top revenue codes are J0717, J3262 and J0129 (biologic injections/infusions), and the claim mix also includes administration codes 96401, 96365 and 96366 which point to regular supervised drug administration rather than purely consultative visits. Office E/M codes such as 99214 and basic infusion administration codes appear as supporting services but generate far less revenue than the biologic drugs themselves, indicating the practice operates an infusion/service line where drug reimbursement is the primary revenue source.

Revenue concentration is very high: the top 3 Medicare codes account for 85.7% of this provider’s total Medicare revenue, led by J0717 at $1M (48.1% of total Medicare revenue), followed by J3262 at $494K (23.3%), and J0129 at $304.3K (14.3%). This skew shows the practice’s financial profile is heavily dependent on a small set of high-cost biologic agents rather than routine office visits or diagnostic testing.

Payer mix is effectively single-payer: lifetime Medicare revenue is $2.1M while Medicaid shows none (no Medicaid billing on file), so the provider is highly exposed to Medicare policy and reimbursement changes and does not appear to participate in Medicaid billing. That single-payer concentration increases revenue vulnerability to Medicare formulary, coverage, or payment updates for high-cost biologics.

For J0717 the provider is a national outlier: J0717 is $1M in revenue and the provider ranks #13 of 848 providers nationally (99th percentile; extreme outlier), which indicates an unusually large national footprint in billing for certolizumab pegol compared with peers. This level of concentration on J0717 suggests either a high local demand for that specific biologic or a practice model built around administering that agent at scale.

Administration and infusion capacity is another competitive strength: 96401 appears at $69K and 1.3K claims with a national rank of #30 of 3868 providers (99th percentile; extreme outlier), and 99214 is $72.8K with 818 claims ranking #18552 of 479517 providers nationally (96th percentile; notably above typical national volume). Together these figures signal above-typical infusion/administration throughput and a higher-than-average office visit volume for established patients relative to national peers.

Secondary biologic agents provide meaningful but non-dominant revenue: J3262 ($494K, 23.3% of Medicare revenue) ranks #54 of 618 providers nationally (91th percentile; typical, unremarkable volume) and J0129 ($304.3K, 14.3%) ranks #546 of 1221 providers nationally (55th percentile; typical, unremarkable volume). These placements indicate strong utilization of multiple biologics without the same extreme concentration seen in J0717.

Operational implications include the need for infusion nursing, drug inventory management, and cold-chain handling given large volumes of physician-supervised injectable biologics and chemotherapy administration codes. The presence of lab codes such as 86200 and 86430 at low volumes is consistent with rheumatology diagnostic testing (e.g., CCP and rheumatoid factor) as adjuncts to a biologic/infusion-focused practice rather than primary revenue drivers.

The provider has an established NPI tenure (enumerated 2017-06-19, ~9 years ago), which supports that these billing patterns are likely deliberate and sustained rather than transient. Given the nearly decade-long enrollment and the high concentration in a few biologic codes, the practice appears to be a specialized rheumatology infusion provider with concentrated Medicare exposure and notable national standing for specific drug administration codes.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

22 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0717	Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	255,000	$1	$1M
J3262	Injection, tocilizumab, 1 mg	98,800	$10	$494K
J0129	Injection, abatacept, 10 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)	8,950	$30	$304.3K
J1602	Injection, golimumab, 1 mg, for intravenous use	6,800	$10	$74.8K
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…	820	$90	$72.8K
96401	The provider administers nonhormonal, antineoplastic chemotherapy drugs subcutaneously or intramuscularly to the patient.	1,280	$50	$69K
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…	460	$70	$31.1K
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.	370	$50	$16.9K
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…	110	$110	$12.4K
86480	The lab analyst performs a test to evaluate a cell mediated immunity gamma interferon antigen response to certain tuberculosis, or TB, antibodies.	110	$60	$6.4K

Showing 1–10 of 22

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 22 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Michael Grant — 9 of 22 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

22 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0717	2	10	57,900	$1	$388K
J3262	2	10	70,740	$1	$328K
J0129	3	10	7,880	$30	$287.1K
J1602	4	10	11,950	$10	$127.5K
96401	1	20	140	$50	$13.7K
99214	63	4,080	80	$80	$11.6K
99213	139	3,680	60	$50	$6.4K
96365	2	80	90	$40	$5.2K
99204	101	1,790	30	$100	$4.1K
86480	2	10	50	$60	$3.8K

Showing 1–10 of 22

Related Providers

Other providers that share a Tax Identification Number (TIN) with Michael Grant, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwest Spine And Pain Care Specialists, LLC	UT	Pain Medicine (Anesthesiology) Physician	$0	$4.1M
Carmen Gota	UT	Rheumatology Physician	$1.2M	$0
Marcia Davis	UT	Acute Care Nurse Practitioner	$823.3K	$0
Shruti Sanghvi	UT	Rheumatology Physician	$642.5K	$6.5K
Bryt Christensen	UT	Interventional Pain Medicine Physician	$463.4K	$2.9K
Rick Obray	UT	Interventional Pain Medicine Physician	$434.8K	$3K
Brian Richardson	UT	Interventional Pain Medicine Physician	$399K	$14.6K
Casey Muir	UT	Interventional Pain Medicine Physician	$364.6K	$0
Stacie Oliver	UT	Pain Medicine (Anesthesiology) Physician	$298.9K	$5.1K
Jon Obray	UT	Interventional Pain Medicine Physician	$284.4K	$750

Nearby Providers

Other providers in the same ZIP code as Michael Grant, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Southwest Utah Community Health Center	UT	Federally Qualified Health Center (FQHC)	$0	$7.3M
Zion Eye Institute, Inc	UT	Ambulatory Surgical Clinic/Center	$6.1M	$19.7K
Summit Behavior Services	UT	Counselor	$0	$5.4M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$4.4M
Ron Lord	UT	Ophthalmology Physician	$3.2M	$0
Joshua Carlson	UT	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
St George Surgical Center LP	UT	Ambulatory Surgical Clinic/Center	$2.5M	$0
Coral Desert Surgery Center LLC	UT	Ambulatory Surgical Clinic/Center	$2.5M	$17.8K
Ihc Health Services Inc	UT	Clinical Medical Laboratory	$2.4M	$42.7K

Michael Grant — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References