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.

Promise Medical PLLC (NPI 1548753866)

Promise Medical PLLC is a primary care clinic/center provider located in Orem, Utah. This profile covers 0 Medicare and 11 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	Promise Medical PLLC
Address	159 N 400 W Unit B-8
City	Orem
State	UT
ZIP	84057
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	June 12, 2018

Payer Source	Total Paid
Medicaid	$925.4K
Medicare	$0

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

11 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	4,000	$120	$475.5K
99417	The provider spends additional time on an outpatient evaluation and management service. Use this code for each additional 15 minutes beyond the minimum required time.	3,040	$50	$161.1K
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…	1,770	$80	$139.4K
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…	2,200	$60	$131.8K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	3,320	$1	$13.3K
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…	30	$100	$3.2K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	80	$10	$660
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	70	$10	$520
90756	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no antibiotics, and is administered as a 0.5 mL injection into…	10	$0	$0
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…	110	$0	$0

Showing 1–10 of 11

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

Promise Medical PLLC — 2 of 8 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

11 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…	223	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…	179	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…	8	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…	103	160	250	$50	$76.9K
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…	181	270	80	$100	$41.6K
80305	The lab analyst performs presumptive drug test(s) by any method that the analyst can read by direct optical observation only, without instrument assistance, to screen for any number of drug classes…	15	110	310	$20	$21.9K
99417	The provider spends additional time on an outpatient evaluation and management service. Use this code for each additional 15 minutes beyond the minimum required time.	2	40	160	$30	$14.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	373	610	140	$10	$13.8K
90674	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no preservatives or antibiotics, and is administered as a 0.5 mL…	12	30	70	$1	$1.4K
90756	This code represents a flu vaccine product that protects against four strains of influenza. It is derived from cell cultures, contains no antibiotics, and is administered as a 0.5 mL injection into…	7	10	40	$20	$640

Showing 1–10 of 11

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Home Health Specialists, LLC	UT	Home Health Agency	$0	$16.1M
Timpanogos Regional Medical Services, Inc.	UT	General Acute Care Hospital	$0	$7.8M
Kids On The Move, Inc.	UT	Developmentally Disabled Services Day Training Agency	$0	$6.7M
Papilion Integrated Recovery Centers	UT	Substance Use Disorder Rehabilitation Clinic/Center	$0	$6.2M
Chrysalis Utah, LLC	UT	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	$0	$4.6M
Kids On The Move, Inc	UT	Developmentally Disabled Services Day Training Agency	$0	$4.4M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$4.2M
City Of Orem Corporation	UT	Land Ambulance	$235.5K	$3.1M
Central Utah Surgicenter, LLC	UT	Ambulatory Surgical Clinic/Center	$2.1M	$28K
Hautoa Enterprises LLC	UT	Substance Abuse Rehabilitation Facility	$49.8K	$1.9M

Promise Medical PLLC — Billing Profile & Reimbursement Data

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Promise Medical PLLC — 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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References