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 1578017067)

Field	Value
Entity Type	Organization
Organization	University Of Utah Pediatric Services
Address	100 N Mario Capecchi Dr
City	Salt Lake City
State	UT
ZIP	84113
Taxonomy	Pediatrics Physician
NPI Enumerated	August 12, 2016

Payer Source	Total Paid
Medicaid	$721.1K
Medicare	$0

Medicaid: Complete Services Breakdown

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

21 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99205	The provider sees a new 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 provider…	1,120	$140	$157.4K
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…	1,310	$120	$152.9K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	700	$130	$91.9K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	610	$150	$90.7K
96101	N/A	190	$480	$88.5K
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.	1,390	$30	$40.2K
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…	680	$40	$23.8K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	40	$460	$18.9K
97165	The occupational therapist (OT) performs an evaluation requiring clinical decision–making of low complexity, which includes analysis of occupational profile, problem–focused assessment data, and…	220	$80	$17K
92521	A speech–language pathologist (SLP) evaluates the patient's speech fluency for issues such as stuttering or cluttering.	160	$80	$12.5K

Showing 1–10 of 21

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 — 3 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

21 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96131	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	12	20	80	$280	$147.8K
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…	1,107	1,340	200	$80	$144K
96130	The provider, physician or other qualified healthcare professional, administers standardized psychological tests to a patient, interprets the results, establishes a treatment plan, and prepares a…	14	20	80	$140	$142.3K
96101	N/A	6	10	190	$300	$115.7K
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…	36	200	240	$90	$85.8K
96112	The provider administers various standardized tests to diagnose developmental problems in children. He interprets the results and prepares a report. Report this code for the first hour of test…	1	10	490	$130	$52.2K
97530	The provider uses various activities during direct contact with the patient to improve the patient’s functional performance. Use this code for each 15 minutes of activity.	84	130	440	$40	$50.7K
92523	A speech–language pathologist (SLP) evaluates the patient's speech sound production for issues such as incorrect pronunciation and patterns.	3	10	60	$140	$45.9K
96136	The provider, a physician or other qualified healthcare professional, administers two or more psychological or neuropsychological tests and scores them. Report this code for the first 30 minutes of…	20	20	120	$80	$35K
97162	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	22	40	80	$70	$23.7K

Showing 1–10 of 21

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
University Of Utah Pediatric Services	UT	Pediatrics 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

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
Ihc Health Services, Inc.	UT	Children's Hospital	$0	$129.5M
University Of Utah Pediatric Acuity Care	UT	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$7.3M
University Of Utah Pediatric Acuity Care	UT	Neonatal-Perinatal Medicine Physician	$0	$3.3M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$2.4M
Ihc Health Services Inc	UT	Pediatric Radiology Physician	$0	$2M
Pediatric Anesthesiologists Inc	UT	Anesthesiology Physician	$0	$2M
University Of Utah Pediatric Acuity Care	UT	Pediatric Critical Care Medicine Physician	$0	$1.5M
Brett Packham	UT	Pediatric Dentistry	$0	$794K
University Of Utah Pediatric Services	UT	Pediatric Gastroenterology Physician	$0	$620.8K
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$559K

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