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.

Marcia Davis (NPI 1528690930)

Field	Value
Entity Type	Individual
Organization	Marcia Davis
Address	3595 S 1550 W
City	Saint George
State	UT
ZIP	84790
Taxonomy	Acute Care Nurse Practitioner
NPI Enumerated	February 4, 2020

Payer Source	Total Paid
Medicare	$823.3K
Medicaid	$0

Key Findings

This provider’s Medicare footprint is the dominant — and effectively sole — payer presence in the record: Total Medicare revenue is $823.3K while there is no Medicaid billing on file, making the practice functionally single-payer at the state Medicaid level. The top 3 Medicare codes by revenue account for 98.6% of this provider's total Medicare revenue, indicating an unusually concentrated revenue base.

Revenue is highly concentrated in three specialty injectable codes: J3111 accounts for $499.9K (61.5% of Medicare revenue), J1306 accounts for $232.6K (28.6%), and J0897 accounts for $69.1K (8.5%), together representing the bulk of billed Medicare dollars. This mix points to a narrow service line dependency on a small set of high-revenue biologic or novel-agent injections rather than broad primary care or procedural revenue.

The code mix — dominated by J3111, J1306, and J0897 — is consistent with a practice model focused on office-administered specialty injectables (romosozumab, inclisiran, denosumab) and aligns with in-office administration workflows rather than high volumes of traditional E/M visits. Supporting this, administration codes 96372 and 96365 appear on the roster of billed services, confirming routine on-site injection and infusion activity.

J3111 shows national-level strength: 62.5K claims generating $499.9K revenue and a rank of #43 of 970 providers nationally (96th percentile; notably above typical national volume for this code). That rank and the code’s share of revenue mark the provider as a major national participant for romosozumab administration relative to peers.

J1306 also represents a sizable specialty volume with 25.8K claims and $232.6K revenue, and the provider ranks #43 of 462 nationally (91th percentile; typical, unremarkable volume for this code). While the percentile and rank place the provider above many peers, available descriptors characterize the billed volume for J1306 as not exceptional for that code class.

J0897 is a much smaller contributor in both counts and competitive standing: 3.8K claims producing $69.1K and a rank of #3661 of 10057 providers (63th percentile; typical, unremarkable volume). This suggests denosumab is a tertiary revenue stream relative to the provider’s primary focus on romosozumab and inclisiran.

Administration activity is a distinct operational signal: 96372 appears as an extreme outlier (763 claims, $6.9K revenue; 0.8% of Medicare revenue) and ranks #744 of 58224 providers nationally (99th percentile; extreme outlier, far above typical national volume for this code). The elevated 96372 activity reinforces that the practice conducts a high frequency of supervised subcutaneous or intramuscular injections in-office.

The provider’s NPI was enumerated on 2020-02-04 (~6 years ago), indicating a relatively recent market entry; combined with the concentrated specialty-revenue profile, this suggests rapid establishment of a targeted injectable therapy practice. The lack of Medicaid billing also implies revenue concentration risk tied to Medicare-covered patients and the specific specialty drugs being administered.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

6 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J3111	Injection, romosozumab-aqqg, 1 mg	62,490	$10	$499.9K
J1306	Injection, inclisiran, 1 mg	25,840	$10	$232.6K
J0897	Injection, denosumab, 1 mg	3,840	$20	$69.1K
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…	760	$10	$6.9K
96365	The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease.	100	$40	$3.9K
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.	40	$20	$600

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 6 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Marcia Davis — 3 of 6 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Utah

Full comparison — all codes billed, vs. state median

6 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J3111	1	10	9,770	$10	$149.8K
J1306	1	10	6,820	$10	$89.3K
J0897	16	70	1,920	$20	$67.2K
96365	39	80	90	$40	$5.2K
99211	26	60	30	$20	$820
96372	3	440	40	$10	$780

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Bioscrip Pharmacy Services, Inc	OH	Home Infusion Therapy Pharmacy	$0	$19.2M
Qureshi Al-owir PLLC	NV	Critical Care Medicine (Internal Medicine) Physician	$0	$7.4M
Southwest Spine And Pain Care Specialists, LLC	UT	Pain Medicine (Anesthesiology) Physician	$0	$4.1M
Michael Grant	UT	Rheumatology Physician	$2.1M	$0
Carmen Gota	UT	Rheumatology Physician	$1.2M	$0
Shruti Sanghvi	UT	Rheumatology Physician	$642.5K	$6.5K
Utah Gastroenterology LLC	UT	Gastroenterology Physician	$0	$613.8K
Bryt Christensen	UT	Interventional Pain Medicine Physician	$463.4K	$2.9K
Rick Obray	UT	Interventional Pain Medicine Physician	$434.8K	$3K
Bassam Al-owir	NV	Critical Care Medicine (Internal Medicine) Physician	$310.4K	$107.6K

Nearby Providers

Other providers in the same ZIP code as Marcia Davis, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Southwest Utah Community Health Center	UT	Federally Qualified Health Center (FQHC)	$0	$7.3M
Zion Eye Institute, Inc	UT	Ambulatory Surgical Clinic/Center	$6.1M	$19.7K
Summit Behavior Services	UT	Counselor	$0	$5.4M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$4.4M
Ron Lord	UT	Ophthalmology Physician	$3.2M	$0
Joshua Carlson	UT	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
St George Surgical Center LP	UT	Ambulatory Surgical Clinic/Center	$2.5M	$0
Coral Desert Surgery Center LLC	UT	Ambulatory Surgical Clinic/Center	$2.5M	$17.8K
Ihc Health Services Inc	UT	Clinical Medical Laboratory	$2.4M	$42.7K

Marcia Davis — Billing Profile & Reimbursement Data

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Marcia Davis — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References