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.

Douglas Plowman (NPI 1255362273)

Field	Value
Entity Type	Individual
Organization	Douglas Plowman
Address	1400 N 500 E
City	Logan
State	UT
ZIP	84341
Taxonomy	Emergency Medical Services (Emergency Medicine) Physician
NPI Enumerated	July 6, 2006

Payer Source	Total Paid
Medicare	$34.8K
Medicaid	$0

Medicare: Complete Services Breakdown

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

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	310	$50	$14K
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…	280	$50	$13.9K
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…	40	$70	$2.8K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	20	$140	$2.3K
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…	10	$90	$1.3K
97597	The provider excises devitalized (dead) tissue from an open wound, choosing from a variety of techniques; treatment may include topical application of medicine or materials, wound assessment,…	10	$30	$350

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Douglas Plowman — 0 of 6 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

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99214	2,958	4,080	80	$80	$11.6K
11042	12	120	90	$70	$9.1K
99213	338	3,680	60	$50	$6.4K
99204	1,472	1,790	30	$100	$4.1K
99205	307	460	20	$140	$4K
97597	45	50	40	$60	$4K

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Rocky Mountain Emergency Specialists LLC	UT	Emergency Medicine Physician	$0	$2.4M
Jacob Sanderson	UT	Family Nurse Practitioner	$118.3K	$0
Jeffrey Baugh	UT	Physician Assistant	$50.4K	$0
Danny Spencer	UT	Emergency Medical Services (Emergency Medicine) Physician	$32.5K	$1.1K
Jeffrey Adams	UT	Physician Assistant	$25.1K	$0

Nearby Providers

Other providers in the same ZIP code as Douglas Plowman, 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
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
Kenneth Fryer	UT	Pediatric Dentistry	$0	$958K

Douglas Plowman — Billing Profile & Reimbursement Data

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Douglas Plowman — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References