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NPI 1205868452 · West Valley City, UT · Pediatrics Physician
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Mary Jane Pennington is a pediatrics physician provider located in West Valley City, Utah. This profile covers 111 Medicare and 12 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 | Mary Jane Pennington |
| Address | 2965 W 3500 S |
| City | West Valley City |
| State | UT |
| ZIP | 84119 |
| Taxonomy | Pediatrics Physician |
| NPI Enumerated | July 7, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $729.8K |
| Medicaid | $15K |
MARY JANE PENNINGTON (Pediatrics Physician, WEST VALLEY CITY, UT) has an established NPI footprint, enumerated 2006-07-07 (~20 years ago), indicating long tenure in billing and claims activity. The taxonomy is Pediatrics Physician, which frames expectations for pediatric-focused services even as the billing mix must be read in that context.
This profile is heavily Medicare‑weighted: Total Medicare revenue is $729.8K while Total Medicaid revenue is $15K, so the provider is effectively Medicare‑dominant in scale. Analysts should treat Medicaid activity as a comparatively small share of the business when modeling payer mix or network leverage.
Revenue concentration is meaningful on both payers: the top 3 Medicare codes account for 38.6% of this provider's total Medicare revenue, while the top 3 Medicaid codes account for 71.0% of this provider's total Medicaid revenue. That concentration indicates the practice derives a large share of income from a short list of diagnostic and collection services and may be sensitive to changes in reimbursement for those specific codes.
The Medicare code mix is lab‑and specimen‑driven: G0482 ($103.6K revenue, 545 claims, 17.4% of Medicare revenue), 36415 (8.6K claims, $68.8K revenue, 11.6% of Medicare revenue), and 80053 (5.7K claims, $57.1K revenue, 9.6% of Medicare revenue) are the top earners, reflecting definitive drug testing, high-volume venipuncture, and comprehensive metabolic panels. This pattern suggests the practice operates significant specimen collection and laboratory billing workflows rather than being dominated by evaluation-and-management or procedure revenue.
Despite meaningful Medicare dollar volumes, competitive standing by code is mostly described as typical: 36415 ranks #249 of 86467 providers nationally (100th percentile; typical, unremarkable volume for this code), 80053 ranks #296 of 26416 providers nationally (99th percentile; typical, unremarkable volume for this code), and G0482 ranks #141 of 1618 providers nationally (91th percentile; typical, unremarkable volume for this code). In plain terms, the provider is a strong national participant in common lab and collection services but not portrayed in the data as an unusual outlier or uniquely dominant provider for these codes.
By contrast, the provider’s Medicaid positioning is modest in‑state: 80053 (the largest Medicaid code) is $6.4K revenue (228 claims, 43.1% of Medicaid revenue) but ranks #77 of 104 providers in-state (26th percentile), and 84443 ($2.1K, 112 claims, 14.4% of Medicaid revenue) ranks #62 of 78 (21th percentile). These low in-state percentiles indicate the provider is not a major Medicaid lab supplier in Utah despite similar types of services appearing on both payers.
Operational throughput is evident from high claim volumes on collection and routine lab panels: 36415 appears with 8.6K Medicare claims and 965 Medicaid claims, while 80053 shows 5.7K Medicare claims and 228 Medicaid claims. Those claim counts point to a practice organized to perform large numbers of venipunctures and send frequent lab panels, which has implications for staffing, phlebotomy capacity, and lab vendor relationships.
The presence of adult‑oriented tests among the top Medicare codes (for example, 84153 PSA at $24K revenue and G0103 PSA screening at $13.9K revenue alongside 84403 testosterone at $14.1K) is noteworthy given the Pediatrics taxonomy; this mix should prompt reviewers to verify specialty alignment for the billed beneficiary populations and to consider whether the provider bills across age groups or for ancillary lab services to other clinicians. Reviewers should be cautious but neutral: the dataset labels these code volumes largely as "typical, unremarkable volume," so the pattern is notable but not flagged by the supplied statistical descriptors as an extreme outlier.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
111 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| G0482 | 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… | 550 | $190 | $103.5K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 8,610 | $10 | $68.8K |
| 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. | 5,710 | $10 | $57.1K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 3,930 | $10 | $51.1K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 2,980 | $20 | $47.7K |
| 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… | 4,370 | $10 | $34.9K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 3,520 | $10 | $31.7K |
| 84153 | The lab analyst performs testing for total prostate specific antigen, PSA, typically on serum or plasma samples using laboratory analyzers. PSA is a protein the prostate gland produces, and… | 1,330 | $20 | $24K |
| 72148 | In this diagnostic procedure, the provider performs magnetic resonance imaging (MRI) of the lumbar spinal canal and contents without using contrast. | 240 | $90 | $21.1K |
| 84403 | The lab analyst performs a test to measure total testosterone, typically in patient serum. | 570 | $30 | $14.1K |
Showing 1–10 of 111
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 111 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
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.
12 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. | 230 | $30 | $6.4K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 110 | $20 | $2.1K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 30 | $70 | $2K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 140 | $10 | $990 |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 970 | $1 | $970 |
| 99000 | Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory. | 420 | $1 | $830 |
| 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… | 220 | $1 | $440 |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 100 | $1 | $410 |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 180 | $1 | $360 |
| 82950 | The lab analyst tests a sample, typically blood, for glucose, also known as blood sugar. The collecting provider takes the sample at a set time after the patient has ingested an amount of liquid or a… | 10 | $10 | $170 |
Showing 1–10 of 12
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
12 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… | 82 | 120 | 1,100 | $30 | $186.6K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 60 | 240 | 220 | $50 | $145.2K |
| 80050 | The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the… | 46 | 50 | 930 | $60 | $102.1K |
| 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. | 77 | 100 | 2,770 | $10 | $75.1K |
| 87086 | Culture, bacterial; quantitative, colony count, urine. | 47 | 60 | 1,050 | $10 | $29.8K |
| 99000 | Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory. | 12 | 30 | 190 | $30 | $27.6K |
| 84443 | The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the… | 62 | 80 | 1,010 | $10 | $23.4K |
| 80061 | The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood. | 50 | 80 | 270 | $10 | $14.6K |
| 83036 | Sugar in the bloodstream can get attached to the hemoglobin in red blood cells. Once the sugar is attached, it stays there for the lifetime of the red blood cell (around 120 days or over 3 months).… | 63 | 130 | 170 | $10 | $9.7K |
| 82043 | The lab analyst quantitates a timed or random urine specimen for the measurement of albumin. Random means the specimen collection may occur without respect to the time of day. This is a valuable… | 25 | 30 | 400 | $10 | $6.4K |
Showing 1–10 of 12
Other providers in the same ZIP code as Mary Jane Pennington, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| University Of Utah Community Physicians Group | UT | General Practice Physician | $0 | $36M |
| Unified Fire Authority-salt Lake | UT | Land Ambulance | $920.5K | $14.6M |
| C.n.s. Corporation | UT | Home Health Agency | $0 | $13.6M |
| West Valley City | UT | Ambulance | $202.1K | $6.2M |
| Unified Health Services LLC | UT | Community Based Hospice Care Agency | $0 | $4.1M |
| Community Nursing Service | UT | Community Based Hospice Care Agency | $0 | $4.1M |
| Granger Pediatric Dentistry | UT | Dental Clinic/Center | $0 | $2.4M |
| Hans Petersen | UT | Pediatric Dentistry | $0 | $1.6M |
| Standard Optical Co | UT | Optometrist | $0 | $1.5M |
| Community Nursing Service | UT | Home Health Agency | $0 | $970.4K |
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