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.

Castleview Physician Practice, LLC (NPI 1396985693)

Castleview Physician Practice, LLC is a surgery physician provider located in Price, Utah. This profile covers 0 Medicare and 17 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	Castleview Physician Practice, LLC
Address	945 W Hospital Dr
City	Price
State	UT
ZIP	84501
Taxonomy	Surgery Physician
NPI Enumerated	February 25, 2009

Payer Source	Total Paid
Medicaid	$508.1K
Medicare	$0

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

17 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…	4,410	$50	$233.5K
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…	2,950	$70	$212.4K
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…	320	$90	$29.6K
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…	200	$100	$19.6K
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…	70	$110	$7.4K
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…	60	$60	$3.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	720	$1	$2.2K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	10	$10	$130
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…	60	$1	$60
1159F	No Summary found for this code	10	$0	$0

Showing 1–10 of 17

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

Castleview Physician Practice, LLC — 0 of 9 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

17 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…	141	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…	103	1,360	190	$70	$125K
87635	Using an amplified nucleic acid probe technique, the lab analyst performs the necessary steps to identify the nucleic acids from the severe acute respiratory syndrome coronavirus 2 (SARS–COV–2) virus…	69	70	340	$50	$117.7K
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…	92	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…	116	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…	93	270	80	$100	$41.6K
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…	167	290	100	$70	$37.1K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	62	70	80	$40	$15.3K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	128	610	140	$10	$13.8K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	114	320	140	$1	$5K

Showing 1–10 of 17

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Castleview Physician Practice, LLC	UT	Family Medicine Physician	$0	$653.9K
David Cragun	UT	Cardiovascular Disease Physician	$465.1K	$940
David Perry	UT	Cardiovascular Disease Physician	$403.9K	$1.4K
Castleview Physician Practices, LLC	UT	Hospitalist Physician	$0	$362.1K
Russell Beecher	UT	Physical Medicine & Rehabilitation Physician	$280K	$0
Eugene Larsen	UT	Internal Medicine Physician	$212K	$0
Joseph Rasband	UT	Diagnostic Radiology Physician	$208.5K	$0
Glenn Etzel	UT	Family Medicine Physician	$158.3K	$0
Kelly Jensen	UT	Orthopaedic Surgery Physician	$111.1K	$6.5K
Brian Griffeth	UT	Foot & Ankle Surgery Podiatrist	$115.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Four Corners Community Behavioral Health, Inc.	UT	Community/Behavioral Health Agency	$0	$19.5M
Castleview Hospital LLC	UT	Rural Acute Care Hospital	$0	$6M
Four Corners Community Behavioral Health, Inc.	UT	Community/Behavioral Health Agency	$0	$2.8M
Shane D Gagon Md, PC	UT	Family Medicine Physician	$0	$2.5M
County Of Carbon	UT	Land Ambulance	$322.9K	$1.8M
A Perfect Smile	UT	Dental Clinic/Center	$0	$1M
Four Corners Community Behavioral Health Inc	UT	Methadone Clinic	$0	$817.1K
West Emergency Services, LLC	UT	Emergency Medicine Physician	$0	$810.3K
Southeastern Utah District Health Department	UT	Public Health or Welfare Agency	$28.8K	$666.5K
Carbon School District	UT	Local Education Agency (LEA)	$0	$622.5K

Castleview Physician Practice, LLC — Billing Profile & Reimbursement Data

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Castleview Physician Practice, LLC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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