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.

After Hours Medical LLC (NPI 1437251279)

After Hours Medical LLC is a urgent care clinic/center provider located in Draper, Utah. This profile covers 0 Medicare and 45 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	After Hours Medical LLC
Address	1126 E 12300 S
City	Draper
State	UT
ZIP	84020
Taxonomy	Urgent Care Clinic/Center
NPI Enumerated	September 2, 2006

Payer Source	Total Paid
Medicaid	$3.2M
Medicare	$0

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

45 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…	21,710	$90	$1.9M
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…	8,060	$90	$749.5K
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…	3,830	$50	$191.5K
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…	2,900	$60	$171K
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…	780	$120	$94.5K
87426	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient blood specimen for antigens of severe acute respiratory syndrome coronavirus such as SARS–CoV–2,…	4,610	$1	$18.4K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	13,540	$1	$13.5K
87804	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect influenza, also called flu, in a patient sample, typically a throat or nasal swab or nasal washings.	11,390	$1	$11.4K
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	370	$30	$11.2K
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…	3,230	$1	$6.5K

Showing 1–10 of 45

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

After Hours Medical LLC — 6 of 20 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

45 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.	68	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…	14	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…	117	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…	57	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…	18	160	250	$50	$76.9K
J1885	Injection, ketorolac tromethamine, per 15 mg	38	70	1,210	$20	$76.7K
J8540	Dexamethasone, oral, 0.25 mg	1	20	60	$110	$45.6K
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…	2	270	80	$100	$41.6K
J7620	Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	2	10	60	$70	$41.5K
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.	76	90	120	$40	$41.1K

Showing 1–10 of 45

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tooele Clinic Corp	UT	Family Medicine Physician	$0	$1.3M
James Mcintyre	UT	Sports Medicine (Family Medicine) Physician	$112.6K	$0
Jason Allen	UT	Physician Assistant	$94K	$0
Olyna Agee	NV	Family Nurse Practitioner	$49.7K	$0
Marilyn Ek	MN	Family Nurse Practitioner	$45.4K	$0
Elizabeth Rogers	ND	Physician Assistant	$43K	$0
Amanda Ward	UT	Family Nurse Practitioner	$42.8K	$0
Troy Eden	NV	Physician Assistant	$33.9K	$490
Medallus & Vacharothone Ltd	ND	Family Medicine Physician	$0	$33.5K
Mckie Delahunty	UT	Physician Assistant	$27.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Beechtree Diagnostics LLP	UT	Clinical Medical Laboratory	$1M	$34.7M
Utah Case Management	UT	Case Management Agency	$0	$13.3M
Lone Peak Hospital, Inc.	UT	General Acute Care Hospital	$0	$4.1M
Rocky Mountain Laboratories LLC	UT	Clinical Medical Laboratory	$224.5K	$2.1M
Utnv Draper Operator, LLC	UT	Assisted Living Facility	$0	$2.2M
Beechtree Molecular Lab LLC	UT	Clinical Medical Laboratory	$236.8K	$862.7K
Draper City	UT	Ambulance	$115.3K	$978.1K
Spencer Hardenbrook	UT	Family Medicine Physician	$965.5K	$3.7K
Jeffrey Welch	UT	General Practice Dentistry	$0	$856.8K
Utah Surgery Center LP	UT	Ambulatory Surgical Clinic/Center	$473.4K	$337.9K

After Hours Medical LLC — Billing Profile & Reimbursement Data

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After Hours Medical 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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