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.

Utah Healthcare Institute Inc (NPI 1376597344)

Utah Healthcare Institute Inc is a family medicine physician provider located in Salt Lake City, Utah. This profile covers 0 Medicare and 52 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	Organization
Organization	Utah Healthcare Institute Inc
Address	1250 E 3900 S
City	Salt Lake City
State	UT
ZIP	84124
Taxonomy	Family Medicine Physician
NPI Enumerated	May 22, 2006

Payer Source	Total Paid
Medicaid	$1.9M
Medicare	$0

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

52 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…	15,140	$70	$1.1M
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…	10,100	$60	$555.5K
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…	650	$100	$66.2K
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…	620	$60	$35.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	7,640	$1	$22.9K
99391	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…	220	$90	$18.3K
90713	This code represents an IPV vaccine product administered beneath the skin or into the muscle to protect against poliomyelitis (polio). This is an inactivated, or killed, virus vaccine.	1,620	$10	$16.2K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	4,940	$1	$14.8K
90686	This code represents a vaccine product administered into the muscle to protect against four strains of influenza (flu). It is preservative free, uses split virus technology, and is given as a 0.5 mL…	3,640	$1	$14.6K
90651	This code represents a nonavalent human papillomavirus (HPV) vaccine product administered into the muscle to protect against HPV infection. The vaccine protects against nine HPV types (6, 11, 16, 18,…	280	$40	$9.8K

Showing 1–10 of 52

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

Utah Healthcare Institute Inc — 6 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. Utah median

52 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	115	240	220	$50	$145.2K
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…	23	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…	38	1,360	190	$70	$125K
99391	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…	104	220	200	$80	$74K
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…	133	190	150	$80	$58.1K
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…	34	270	80	$100	$41.6K
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	39	50	180	$50	$37.6K
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…	53	290	100	$70	$37.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	70	150	60	$70	$32.2K
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	24	70	290	$20	$27.5K

Showing 1–10 of 52

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Northern Utah Healthcare Corporation	UT	General Acute Care Hospital	$0	$35.7M
Nomi Health Inc.	UT	Clinical Medical Laboratory	$108.9K	$9.1M
Valley Mental Health Incorporated	UT	Physical Disabilities Residential Treatment Facility	$0	$5M
Valleylab	UT	Clinical Medical Laboratory	$0	$2.7M
Valley Mental Health Incorporated	UT	Home Health Registered Nurse	$0	$1.3M
Creek Capital East Gate LLC	UT	Pediatric Dentistry	$0	$570.9K
Wasatch Endoscopy Center Ltd	UT	Ambulatory Surgical Clinic/Center	$486.9K	$62.1K
St Marks Ambulatory Surgery Associates LP	UT	Ambulatory Surgical Clinic/Center	$512.1K	$0
Adult Care Clinic Inc	UT	Acute Care Nurse Practitioner	$0	$474.8K
James Shortridge	UT	Hematology & Oncology Physician	$221.4K	$177.5K

Utah Healthcare Institute Inc — Billing Profile & Reimbursement Data

Sign up for Utah Healthcare Institute Inc — Billing Profile & Reimbursement Data policy alerts

Utah Healthcare Institute Inc — Billing Profile & Reimbursement Data

Sign up for Utah Healthcare Institute Inc — 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