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.

Wendell Nilson (NPI 1205883576)

Wendell Nilson is a pediatrics physician provider located in Saint George, Utah. This profile covers 0 Medicare and 16 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Individual
Organization	Wendell Nilson
Address	1240 E 100 S Ste 14
City	Saint George
State	UT
ZIP	84790
Taxonomy	Pediatrics Physician
NPI Enumerated	May 30, 2006

Payer Source	Total Paid
Medicaid	$377.7K
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	3,430	$70	$226.6K
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…	1,220	$90	$113.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	190	$90	$16.1K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	590	$20	$11.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	40	$100	$3.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	40	$90	$3.6K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	1,020	$1	$2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	180	$1	$530
87077	The lab analyst performs additional tests on a presumptively identified aerobic isolate to definitively, which means more specifically, identify the organism, such as to the level of species.	40	$1	$80
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	30	$1	$30

Showing 1–10 of 16

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

Wendell Nilson — 0 of 10 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

16 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	283	1,340	200	$80	$144K
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…	130	1,360	190	$70	$125K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	139	190	150	$80	$58.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	57	150	60	$70	$32.2K
87070	The lab analyst performs the technical lab steps to culture a specimen from any source except urine, blood, or stool. This service involves aerobic culture, which refers to the presence of oxygen.…	23	30	210	$20	$26.1K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	62	90	90	$60	$22.4K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	4	50	160	$10	$17.5K
87081	The lab analyst cultures a patient specimen on a test medium designed to grow only a specific pathogenic organism.	26	50	150	$10	$17K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	143	610	140	$10	$13.8K
87077	The lab analyst performs additional tests on a presumptively identified aerobic isolate to definitively, which means more specifically, identify the organism, such as to the level of species.	26	30	700	$10	$13.2K

Showing 1–10 of 16

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

Wendell Nilson — Billing Profile & Reimbursement Data

Sign up for Wendell Nilson — Billing Profile & Reimbursement Data policy alerts

Wendell Nilson — Billing Profile & Reimbursement Data

Sign up for Wendell Nilson — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References