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.

Tanner Memorial Clinic (NPI 1447239355)

Key Findings

Field	Value
Entity Type	Organization
Organization	Tanner Memorial Clinic
Address	2121 N 1700 W
City	Layton
State	UT
ZIP	84041
Taxonomy	Internal Medicine Physician
NPI Enumerated	January 10, 2006

Payer Source	Total Paid
Medicaid	$8.1M
Medicare	$0

TANNER MEMORIAL CLINIC is effectively a Medicaid-focused practice: lifetime Medicaid revenue is $8.1M while there is no Medicare billing on file. This makes the provider functionally single‑payer in the available data, so analyses of utilization and competitive position should be interpreted in a Medicaid-only context rather than a mixed Medicare/Medicaid practice model.

Revenue is highly concentrated in a small set of evaluation-and-management (E/M) visit codes: the precomputed top 3 Medicaid codes account for 77.4% of the provider’s total Medicaid revenue. Those top contributors are 99214 (46.6K claims, $51 avg paid/claim, $2.4M revenue, 31.9%), 99213 (50.8K claims, $46 avg paid/claim, $2.3M revenue, 31.4%), and 99215 (14.9K claims, $71 avg paid/claim, $1.1M revenue, 14.2%), indicating the vast majority of dollars are coming from office/outpatient E/M encounters.

The code mix and volumes point to a high-volume primary care/internal medicine ambulatory practice model: 99214 and 99213 (established patient E/M at moderate and low complexity) together represent more than 60% of Medicaid revenue and carry very large claim counts (46.6K and 50.8K claims respectively). The presence of 99215 (high-complexity established visits) at meaningful revenue share suggests the clinic manages a nontrivial number of complex, time‑intensive visits alongside routine chronic care.

State competitive standing is dominant for core ambulatory E/M codes: 99214 ranks #5 of 1340 providers in-state and is labeled an extreme outlier, and 99213 ranks #7 of 1355 providers in-state and is likewise an extreme outlier. 99215 ranks #3 of 199 providers (99th percentile; extreme outlier), so for established office visits this provider is a major outlier and a top statewide billing source in these services.

While E/M visits dominate, the clinic also bills a range of ancillary services that support comprehensive outpatient care: 87635 (COVID NAAT testing) produced $182.6K (2.5%); 43239 (EGD with biopsy) produced $143.2K (1.9%); and vaccinations and basic lab services such as 90471 (10K claims, $5 avg, $50.1K) and 36415 (12.3K claims, $7 avg, $86.2K) appear in the top codes. This mix suggests on-site testing, immunizations, and some procedural capacity in addition to high-volume office visits.

Several non‑established visit and preventive codes also appear at above-typical volumes for the state, indicating a broader ambulatory footprint: 99203 (4.1K claims, $210.9K, ranks #6 of 294; 98th percentile, notably above typical) and 99391 (3K claims, $211.2K; 93th percentile, typical) both contribute to new-patient and preventive care activity. These volumes imply the practice is handling both new patient intake and routine prevention alongside its dominant established-patient workload.

The provider’s payment mix reflects high throughput with relatively low per-claim Medicaid reimbursement on frequent visit codes: the most-revenue E/M codes show average paid/claim values of $51 (99214), $46 (99213), and $71 (99215). Combined with the high claim counts, this pattern is consistent with a large primary care panel serving Medicaid enrollees where visit volume — not high per-encounter reimbursement — drives overall revenue.

Operational tenure is long-form and may underlie the high market position: the NPI was enumerated on 2006-01-10 (~20 years ago). Long standing in the market, together with extreme-outlier ranking on core E/M codes, supports the interpretation of the clinic as an established, high-volume Medicaid outpatient provider in Utah rather than a recent entrant.

Medicaid: Complete Services Breakdown

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

204 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…	46,550	$50	$2.4M
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…	50,770	$50	$2.3M
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…	14,850	$70	$1.1M
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…	3,020	$70	$211.2K
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…	4,060	$50	$210.9K
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…	3,800	$50	$182.6K
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…	3,050	$60	$180.1K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	920	$160	$143.2K
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…	1,540	$60	$89.3K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	12,320	$10	$86.2K

Showing 1–10 of 204

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

Tanner Memorial Clinic — 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

204 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	164	370	690	$140	$704.2K
90791	In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis.	44	140	160	$220	$374.1K
80307	The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.	45	70	1,610	$30	$367.9K
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…	45	120	1,100	$30	$186.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	11	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…	5	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…	7	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…	4	70	340	$50	$117.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	66	90	460	$50	$115K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	14	50	930	$60	$102.1K

Showing 1–10 of 204

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Gregory Austad	UT	Rheumatology Physician	$963.9K	$0
Justin Mansfield	UT	Internal Medicine Physician	$716.3K	$0
Andrew Coles	UT	Interventional Pain Medicine Physician	$389.6K	$120.9K
Laurence Nelson	UT	Ophthalmology Physician	$367.8K	$0
Michael Martineau	UT	Dermatology Physician	$323.3K	$0
Glen Biddulph	UT	Internal Medicine Physician	$214.4K	$0
Tyler Williams	UT	Internal Medicine Physician	$179.2K	$0
David Stevens	UT	Orthopaedic Surgery Physician	$160.6K	$0
Amandeep Chadha	UT	Nephrology Physician	$158.8K	$0
Hu Ding	UT	Anatomic Pathology & Clinical Pathology Physician	$147.3K	$20

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Davis Behavioral Health Inc	UT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$70.8M
Davis Hospital & Medical Center LP	UT	General Acute Care Hospital	$0	$22.5M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$11.6M
Layton City Corporation	UT	Land Ambulance	$377.7K	$4.7M
Hillfield Pediatric & Family Dentistry Inc.	UT	General Practice Dentistry	$0	$3.1M
Catalyst Behavior Solutions	UT	Community/Behavioral Health Agency	$0	$2.8M
Silver Lake Healthcare, Inc.	UT	Community Based Hospice Care Agency	$0	$2.4M
Scott Folkman	UT	Pediatric Dentistry	$0	$2M
Discovery House Lt, Inc.	UT	Methadone Clinic	$76.3K	$1.8M
Silver Lake Healthcare, Inc.	UT	Home Health Agency	$0	$1.6M

Tanner Memorial Clinic — Billing Profile & Reimbursement Data

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Tanner Memorial Clinic — Billing Profile & Reimbursement Data

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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