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.

Brandt Esplin (NPI 1285929430)

Field	Value
Entity Type	Individual
Organization	Brandt Esplin
Address	1055 N 500 W Ste 202, Bldg C
City	Provo
State	UT
ZIP	84604
Taxonomy	Hematology & Oncology Physician
NPI Enumerated	June 16, 2011

Payer Source	Total Paid
Medicare	$1.1M
Medicaid	$0

Key Findings

BRANDT ESPLIN is enumerated as a Hematology & Oncology Physician and the Medicare billing mix is heavily weighted toward infused biologic agents and oncology infusions, with top codes dominated by J9271, J0897 and J3380. The three highest-revenue codes are J9271 ($430.6K, 41.5%), J0897 ($277.6K, 26.7%), and J3380 ($120.1K, 11.6%), which aligns with a practice model centered on high-cost injectable therapies rather than primary-care office volume.

Revenue concentration is pronounced: the precomputed top-3 codes account for 79.7% of this provider's total Medicare revenue. That level of concentration means a small set of biologic/injectable agents drives the majority of Medicare payments to this NPI and could make overall revenue sensitive to changes in utilization or reimbursement for those specific drugs.

This provider is effectively single-payer in public programs — Medicare revenue totals $1.1M while there is no Medicaid billing on file. The absence of Medicaid activity indicates either no participation in that program or negligible billing to Medicaid, so analyses and benchmarking should treat this as a Medicare-focused profile.

Competitive standing across the top codes is mixed: J0897 (denosumab) shows a strong national position, ranking #506 of 10057 providers nationally (95th percentile; notably above typical national volume) and contributing $277.6K (26.7%) to Medicare revenue. By contrast, J9271 (pembrolizumab) at $430.6K (41.5%) ranks #1181 of 1841 (36th percentile; typical) and J3380 at $120.1K (11.6%) ranks #330 of 620 (47th percentile; typical), so the practice is a particularly high-volume outlier for denosumab but has more typical volumes for other leading biologics.

Office evaluation and chemotherapy administration codes support an active clinical oncology practice alongside infusion services: 99214 generated $45.7K (4.4%) with 514 claims and ranks in the 90th percentile nationally, while 96413 generated $31.7K (3.1%) with 345 claims and ranks in the 80th percentile. Those E/M and chemotherapy administration volumes are consistent with ongoing management of established oncology patients and in-office infusion throughput.

There are additional notable statistical signals among lower-revenue codes that speak to procedure throughput rather than revenue share: J3489 (zoledronic acid) shows 409 claims and $2.5K revenue while ranking #103 of 3032 providers nationally (97th percentile; notably above typical national volume), and 96372 has 494 claims and $4.9K revenue while ranking in the 97th percentile. Both suggest frequent use of ancillary injectable treatments and high procedural volume even when each claim contributes modest revenue.

The provider has been NPI-enumerated since 2011-06-16 (~15 years ago), indicating an established presence in the market. Coupled with $1.1M in lifetime Medicare revenue, the profile is that of a modest-sized, experienced oncology/infusion practice that is Medicare-centric and operationally focused on biologic drug administration.

From a competitive and contracting perspective, the practice’s strengths are its high relative volume in specific injectable agents (notably J0897) and consistent chemotherapy/E/M activity; however, the lack of Medicaid billing limits visibility and negotiating leverage in Medicaid networks and means payers should treat this entity primarily as a Medicare-facing infusion provider.

Medicare: Complete Services Breakdown

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

45 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J9271	Injection, pembrolizumab, 1 mg	10,020	$40	$430.6K
J0897	Injection, denosumab, 1 mg	15,420	$20	$277.6K
J3380	Injection, vedolizumab, intravenous, 1 mg	7,510	$20	$120.1K
J3111	Injection, romosozumab-aqqg, 1 mg	7,140	$10	$57.1K
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…	510	$90	$45.7K
96413	Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These…	350	$90	$31.7K
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.	320	$40	$14.2K
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…	70	$160	$10.4K
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.	580	$10	$5.8K
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…	690	$10	$5.6K

Showing 1–10 of 45

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 45 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Brandt Esplin — 5 of 25 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

45 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J9271	2	10	10,010	$40	$510.2K
J3111	5	10	9,770	$10	$149.8K
J3380	4	10	9,900	$20	$140.4K
J0897	3	70	1,920	$20	$67.2K
96413	4	50	100	$90	$13.8K
96401	10	20	140	$50	$13.7K
99214	199	4,080	80	$80	$11.6K
99215	809	1,190	40	$110	$7.5K
96365	5	80	90	$40	$5.2K
99205	20	460	20	$140	$4K

Showing 1–10 of 45

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Revere Health PC	UT	Multi-Specialty Clinic/Center	$0	$24M
Joseph Te	UT	Hematology & Oncology Physician	$1.6M	$0
Jamison Jones	UT	Cardiovascular Disease Physician	$1M	$0
Steven Wallentine	UT	Hematology & Oncology Physician	$1M	$7.6K
Robert Dowse	UT	Pediatrics Physician	$0	$867K
David Slade	UT	Ophthalmology Physician	$651.1K	$0
Marc Nuttall	UT	Hematology & Oncology Physician	$549.1K	$580
Leslee Adams	UT	Family Nurse Practitioner	$513.4K	$0
David Cragun	UT	Cardiovascular Disease Physician	$465.1K	$940
James Macdonald	UT	Dermatology Physician	$415.3K	$26.5K

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Utah Valley Pediatrics L.L.C.	UT	Pediatrics Physician	$0	$11.9M
Riverwoods Surgery Center, LLC	UT	Ambulatory Surgical Clinic/Center	$737.9K	$5M
Utah Valley Emergency Physicians Inc	UT	Emergency Medicine Physician	$0	$4.7M
Ryan Isom	UT	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Jack Stringham	UT	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$3.3M
Richard Corey	UT	Retina Specialist (Ophthalmology) Physician	$3M	$50.1K
Provo City Board Of Education	UT	Local Education Agency (LEA)	$0	$3M
Robert Welch	UT	Retina Specialist (Ophthalmology) Physician	$2.5M	$0

Brandt Esplin — 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