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.

Odyssey House Inc (NPI 1407481245)

Field	Value
Entity Type	Organization
Organization	Odyssey House Inc
Address	743 E 300 S
City	Salt Lake City
State	UT
ZIP	84102
Taxonomy	Family Medicine Physician
NPI Enumerated	March 11, 2020

Payer Source	Total Paid
Medicaid	$10.1M
Medicare	$0

Key Findings

ODYSSEY HOUSE INC reports no Medicare billing on file and $10.1M in lifetime Medicaid revenue, so its public payment footprint is effectively single‑payer Medicaid. The provider’s NPI was enumerated 2020-03-11 (~6 years ago), indicating roughly six years of recorded billing history under the current identifier.

Revenue is highly concentrated: the precomputed top three Medicaid codes (99214, 96372, 99213) account for 74.1% of the provider’s total Medicaid revenue. Individually, 99214 represents $4.4M revenue (43.7% of Medicaid revenue), 96372 $1.7M (17.1%), and 99213 $1.3M (13.3%), showing these outpatient evaluation/management and injection administration codes drive the bulk of receipts.

The code mix (high volumes of 99214 and 99213 plus large volume of 96372) is consistent with a high‑throughput primary care or ambulatory treatment operation that performs frequent office E&M visits and on‑site injectable medication administration. The presence of substantial J2315 and Q9991/Q9992 billing further indicates that medication‑assisted treatment for substance use disorders is a meaningful service line alongside routine primary care.

ODYSSEY HOUSE is a dominant in‑state performer on several high‑revenue services: 99214 ranks #16 of 1340 providers in Utah (99th percentile), placing it well above typical state volume for that code. By contrast, 96372 (rank #7 of 164, 96th percentile) and 99213 (rank #53 of 1355, 96th percentile) are high percentiles but described as typical or unremarkable relative to peers, so the provider’s standout position is strongest for higher‑level established visit billing.

The provider shows specialization in injectable addiction treatments: J2315 (naltrexone depot) is $758.9K in revenue (7.5% of Medicaid revenue) and ranks #1 of 6 providers in‑state (100th percentile), described as notably above typical state volume. Q9991 and Q9992 (buprenorphine extended‑release) are also reported and rank #1 of 1 providers in the state (no peer volume comparison available), making this one of the few state billers for those specific extended‑release formulations.

Drug testing and specimen services are a significant operational feature: 80305 is an extreme outlier with 19.1K claims and $76.4K revenue (0.8% of Medicaid revenue), ranking #1 of 107 providers in‑state and flagged as far above typical state volume. High volumes of specimen collection for SARS‑CoV‑2 (G2023: 7.3K claims, $109.7K, 1.1%) and blood draws (36415: 3.5K claims, $10.5K) support an on‑site or affiliated lab and screening workflow tied to the clinic’s visit volume.

Lower‑intensity office visits and care coordination are also present at scale: 99211 appears with 7.7K claims generating $270.4K (2.7% of Medicaid revenue) and ranks #4 of 85 in‑state (96th percentile), and chronic care management 99490 appears across 1.1K claims ($10.8K). These code patterns suggest a mixed encounter profile where brief, non‑physician visits and monthly care‑coordination services complement higher‑level E&M and injection encounters.

From a payer/contracting perspective, the business is materially concentrated on a small set of outpatient E&M and injection codes (top three = 74.1% of Medicaid revenue) and has no Medicare revenue to diversify payer mix. That concentration and the provider’s leading in‑state positions on several codes imply both negotiating leverage within Medicaid networks for those services and exposure if state reimbursement or utilization policies change for high‑volume codes.

Medicaid: Complete Services Breakdown

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

40 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…	20,740	$210	$4.4M
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	7,030	$250	$1.7M
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…	7,620	$180	$1.3M
J2315	Injection, naltrexone, depot form, 1 mg	2,950	$260	$758.9K
99215	The provider sees an established 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…	3,830	$140	$532.4K
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…	2,270	$170	$374.6K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	7,730	$40	$270.4K
Q9991	Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg	410	$460	$187.9K
Q9992	Injection, buprenorphine extended-release (sublocade), greater than 100 mg	240	$530	$126.4K
G2023	Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	7,310	$20	$109.7K

Showing 1–10 of 40

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

Odyssey House Inc — 11 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

40 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J2315	Injection, naltrexone, depot form, 1 mg	1	10	610	$180	$197.1K
Q9991	Injection, buprenorphine extended-release (sublocade), less than or equal to 100 mg	1	10	410	$460	$187.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	30	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…	16	1,340	200	$80	$144K
Q9992	Injection, buprenorphine extended-release (sublocade), greater than 100 mg	1	10	240	$530	$126.3K
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…	53	1,360	190	$70	$125K
99215	The provider sees an established 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…	10	200	240	$90	$85.8K
96372	A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician…	7	160	250	$50	$76.9K
J1885	Injection, ketorolac tromethamine, per 15 mg	57	70	1,210	$20	$76.7K
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	270	80	$100	$41.6K

Showing 1–10 of 40

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Odyssey House Inc	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$84.5M
Richard Arbogast	UT	Family Medicine Physician	$0	$2.5M
Jessica Latham	UT	Medical Physician Assistant	$60.1K	$0

Nearby Providers

Other providers in the same ZIP code as Odyssey House Inc, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Physicians Integrated Care, LLC	UT	Emergency Medicine Physician	$0	$31.2M
Helping Hand Association	UT	Substance Abuse Rehabilitation Facility	$0	$18.4M
House Of Hope	UT	Substance Abuse Rehabilitation Facility	$0	$11.6M
Salt Lake Regional Medical Center LP	UT	General Acute Care Hospital	$0	$9.8M
Lyssa Inc	UT	Ambulatory Surgical Clinic/Center	$0	$7.2M
First Step House	UT	Clinical Medical Laboratory	$0	$2.3M
Planned Parenthood Association Of Utah	UT	Voluntary or Charitable Agency	$0	$1.4M
University Of Utah Behavioral Health Services	UT	Psychiatry Physician	$0	$1.3M
S-h Opco Salt Lake City, LLC	UT	Assisted Living Facility	$0	$879.2K
Ihc Health Services Inc	UT	Internal Medicine Physician	$0	$854K

Odyssey House Inc — Billing Profile & Reimbursement Data

Sign up for Odyssey House Inc — Billing Profile & Reimbursement Data policy alerts

Odyssey House Inc — Billing Profile & Reimbursement Data

Sign up for Odyssey House Inc — Billing Profile & Reimbursement Data policy alerts

Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References