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.

Michael Whiting (NPI 1548220148)

Michael Whiting is a pediatric adolescent medicine physician provider located in American Fork, Utah. This profile covers 0 Medicare and 33 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	Individual
Organization	Michael Whiting
Address	48 N 1100 E
City	American Fork
State	UT
ZIP	84003
Taxonomy	Pediatric Adolescent Medicine Physician
NPI Enumerated	March 27, 2006

Payer Source	Total Paid
Medicaid	$827.1K
Medicare	$0

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

33 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…	4,660	$60	$289.2K
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…	2,150	$120	$257.4K
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…	1,560	$90	$134.5K
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…	830	$80	$67.5K
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…	410	$90	$34.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	200	$70	$13.9K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	2,360	$1	$7.1K
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.	430	$20	$6.9K
85018	The lab analyst measures the hemoglobin in a whole blood sample. Hemoglobin is the red pigmented iron compound contained in the red blood cell that combines with oxygen needed by the body tissue.	980	$1	$3.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	1,630	$1	$3.3K

Showing 1–10 of 33

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

Michael Whiting — 0 of 21 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

33 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…	233	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…	94	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…	23	200	240	$90	$85.8K
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…	48	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…	66	190	150	$80	$58.1K
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.	27	90	120	$40	$41.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	55	150	60	$70	$32.2K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	59	90	90	$60	$22.4K
81002	The lab analyst inserts a dip stick into a freshly collected urine specimen, removes the dip stick, and shakes off the excess urine. Alternatively, the analyst may place drops of the urine specimen…	32	50	160	$10	$17.5K
J7613	Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg	6	10	290	$40	$16.4K

Showing 1–10 of 33

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$17.2M
Alpine School District	UT	Local Education Agency (LEA)	$0	$8.4M
Star Kids	UT	Home Health Agency	$0	$5M
American Fork City Corporation	UT	Land Ambulance	$188.3K	$2.8M
Alliance Youth Services	UT	Foster Care Agency	$0	$2.5M
Smith And Macdonald Pediatric Dentistry	UT	Pediatric Dentistry	$0	$2.3M
North Valley Emergency Physicians Lc	UT	Emergency Medical Services (Emergency Medicine) Physician	$0	$1.5M
Chad Gollaher	UT	Pediatric Dentistry	$0	$759.4K
David Macdonald	UT	Pediatric Dentistry	$0	$729.9K
Don Boren	UT	General Practice Dentistry	$0	$679.4K

Michael Whiting — Billing Profile & Reimbursement Data

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Michael Whiting — 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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