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.

University Of Utah Pediatric Services (NPI 1568826055)

Field	Value
Entity Type	Organization
Organization	University Of Utah Pediatric Services
Address	50 N Medical Dr
City	Salt Lake City
State	UT
ZIP	84132
Taxonomy	Pediatrics Physician
NPI Enumerated	April 11, 2016

Payer Source	Total Paid
Medicaid	$3.1M
Medicare	$0

Medicaid: Complete Services Breakdown

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

77 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…	11,080	$60	$620.7K
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…	7,050	$80	$535.4K
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…	5,380	$90	$484K
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…	4,530	$80	$366.5K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	4,970	$40	$174K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	1,990	$80	$165.5K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,800	$70	$125.7K
99238	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…	2,550	$40	$101.9K
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…	850	$100	$80.7K
99487	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	850	$90	$74.9K

Showing 1–10 of 77

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

University Of Utah Pediatric Services — 12 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

77 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	92	120	1,100	$30	$186.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	47	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…	68	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…	35	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…	58	70	340	$50	$117.7K
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…	54	200	240	$90	$85.8K
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.	72	100	2,770	$10	$75.1K
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…	6	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…	7	190	150	$80	$58.1K
82306	The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…	35	50	240	$30	$48.7K

Showing 1–10 of 77

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Of Utah Pediatric Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Utah Adult Services	UT	Ophthalmology Physician	$0	$3.1M
Christopher Komanski	NC	Ophthalmology Physician	$2.3M	$0
University Of Utah Pediatric Services	UT	Pediatric Cardiology Physician	$0	$2.2M
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$1.6M
University Of Utah Pediatric Services	UT	Ophthalmology Physician	$0	$1.3M
University Of Utah Pediatric Services	UT	Child & Adolescent Psychiatry Physician	$0	$1.2M
University Of Utah Pediatric Services	UT	Hematology & Oncology Physician	$0	$925.3K
University Of Utah Pediatric Services	UT	Pediatric Otolaryngology Physician	$0	$843.3K
University Of Utah Pediatric Services	UT	Pediatric Orthopaedic Surgery Physician	$0	$829.4K
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$721.1K

Nearby Providers

Other providers in the same ZIP code as University Of Utah Pediatric Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Utah	UT	General Acute Care Hospital	$0	$221.3M
University Of Utah Adult Services	UT	Emergency Medicine Physician	$0	$6.9M
University Of Utah Adult Services	UT	Diagnostic Radiology Physician	$0	$4M
University Of Utah Adult Services	UT	Internal Medicine Physician	$0	$3.5M
University Of Utah Adult Services	UT	Anesthesiology Physician	$0	$3M
Dermatology Division University Of Utah Medical Center	UT	Dermatology Physician	$0	$1.4M
University Of Utah Specialty Services	UT	Maternal & Fetal Medicine Physician	$0	$1.4M
University Of Utah Adult Services	UT	Cardiovascular Disease Physician	$0	$1.2M
University Of Utah Specialty Services	UT	Physical Medicine & Rehabilitation Physician	$0	$1.1M
University Of Utah Adult Services	UT	Anatomic Pathology & Clinical Pathology Physician	$0	$1.1M

University Of Utah Pediatric Services — Billing Profile & Reimbursement Data

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University Of Utah Pediatric Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References