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.

Seth Wallace (NPI 1245441971)

Field	Value
Entity Type	Individual
Organization	Seth Wallace
Address	550 E 1400 N Ste S
City	Logan
State	UT
ZIP	84341
Taxonomy	Sleep Medicine (Family Medicine) Physician
NPI Enumerated	May 24, 2007

Payer Source	Total Paid
Medicare	$29.3K
Medicaid	$0

Medicare: Complete Services Breakdown

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

7 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	90	$90	$8.6K
95811	During the study, the physician monitors the sleep pattern of the patient, along with different bodily functions during the sleep cycle extending over a period of six hours or more.	90	$90	$8.2K
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…	30	$120	$3.2K
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…	50	$60	$3.1K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	30	$90	$2.9K
95806	A technologist is not in attendance during this sleep study, which involves measuring several parameters while the patient sleeps in a clinic or sleep lab to help diagnose sleep disorders.	90	$30	$2.6K
99203	The provider sees a new 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 provider…	10	$60	$750

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 7 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Seth Wallace — 0 of 7 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

7 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95811	14	30	50	$210	$18.8K
95810	16	30	50	$250	$17.1K
99214	1,804	4,080	80	$80	$11.6K
99213	2,094	3,680	60	$50	$6.4K
99204	861	1,790	30	$100	$4.1K
95806	9	30	50	$40	$2.9K
99203	1,187	1,360	30	$70	$2.7K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$25.3M
Mountain Division - Cvh, LLC	UT	General Acute Care Hospital	$0	$4.4M
Team Recovery	UT	Substance Abuse Rehabilitation Facility	$0	$3M
Cache County School District	UT	Local Education Agency (LEA)	$0	$2.9M
Ihc Health Services Inc	UT	Internal Medicine Physician	$0	$2.8M
Rocky Mountain Emergency Specialists LLC	UT	Emergency Medicine Physician	$0	$2.4M
Corey Walker	UT	Rheumatology Physician	$2.3M	$0
Bear River District Health Dept	UT	Public Health or Welfare Agency	$99.1K	$2.1M
Bear River District Health Dept	UT	Addiction (Substance Use Disorder) Counselor	$0	$1.7M
Daren Gehring	UT	Pediatric Dentistry	$0	$1M

Seth Wallace — Billing Profile & Reimbursement Data

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Seth Wallace — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References