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.

Blue Mountain Hospital (NPI 1558513812)

Blue Mountain Hospital is a critical access hospital clinic/center provider located in Blanding, Utah. This profile covers 0 Medicare and 51 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	Blue Mountain Hospital
Address	802 S 200 West
City	Blanding
State	UT
ZIP	84511
Taxonomy	Critical Access Hospital Clinic/Center
NPI Enumerated	October 17, 2008

Payer Source	Total Paid
Medicaid	$567.4K
Medicare	$0

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

51 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	2,810	$60	$171.7K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	3,680	$30	$125K
8888888	N/A	120	$400	$47.6K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	4,320	$10	$47.5K
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…	4,730	$10	$28.4K
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…	200	$130	$26.5K
70450	The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.	250	$100	$26K
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…	210	$90	$18.2K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	1,230	$10	$9.8K
81000	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…	2,750	$1	$8.3K

Showing 1–10 of 51

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

Blue Mountain Hospital — 2 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

51 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
8888888	N/A	55	60	8,900	$400	$9.5M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	16	20	630	$750	$1.2M
G0481	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	12	20	660	$60	$625K
00170	The provider performs anesthesia services for a patient undergoing an intraoral procedure, including biopsy.	31	40	270	$290	$381.5K
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	119	160	190	$70	$283.2K
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	45	190	200	$50	$239.5K
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…	31	120	1,100	$30	$186.6K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	39	50	4,040	$30	$186.4K
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	44	190	250	$40	$146.8K
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…	672	1,340	200	$80	$144K

Showing 1–10 of 51

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Blue Mountain Hospital	UT	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$1.8M
Steven Hillam	UT	Ophthalmology Physician	$222.9K	$0
Mahana Fisher	UT	Family Medicine Physician	$144.9K	$10.4K
Richard Ward	UT	Physical Therapist	$76.6K	$0
Lloyd Jones	UT	Family Medicine Physician	$39K	$9.4K
Dashelle Holliday	UT	Nurse Practitioner	$37.3K	$0
Trent Bell	UT	Certified Registered Nurse Anesthetist	$24.8K	$0
Alan Ward	UT	Occupational Therapist	$24.4K	$0
Wendell Key	UT	Family Medicine Physician	$11.4K	$2.1K
Wendell Gibby	UT	Diagnostic Radiology Physician	$13K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
San Juan Mental Health-substance Abuse Special Service District	UT	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$5.1M
Guardian Flight LLC	UT	Air Ambulance	$470.2K	$3.8M
Utah Navajo Health System, Incorporated	UT	Family Medicine Physician	$0	$2.5M
Acorn Care LLC	UT	In Home Supportive Care Agency	$0	$1.2M
Precision Rehabilitation PC	UT	Physical Therapist	$0	$398.1K
San Juan County Hospital	UT	Rural Health Clinic/Center	$0	$386.2K
San Juan School District	UT	Local Education Agency (LEA)	$0	$361.3K
Joseph Walker	UT	Physician Assistant	$7.2K	$0
Revina Talker	UT	Physician Assistant	$4.8K	$0

Blue Mountain Hospital — Billing Profile & Reimbursement Data

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Blue Mountain Hospital — 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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