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.

Ogden Clinic PC (NPI 1578550083)

Key Findings

Field	Value
Entity Type	Organization
Organization	Ogden Clinic PC
Address	4650 Harrison Blvd
City	Ogden
State	UT
ZIP	84403
Taxonomy	Family Medicine Physician
NPI Enumerated	September 29, 2005

Payer Source	Total Paid
Medicaid	$8.3M
Medicare	$0

OGDEN CLINIC PC is effectively a single-payer Medicaid practice: there is no Medicare billing on file and the provider reports $8.3M in lifetime Medicaid revenue, making Medicaid the sole documented source of fee-for-service revenue for this NPI. This payer concentration shapes the provider’s operational and revenue priorities toward Medicaid-covered primary care and related services.

Revenue is highly concentrated in a very small set of codes: the precomputed top three Medicaid codes (99214, 99213, 87428) account for 74.9% of this provider’s total Medicaid revenue. In dollar terms those contributors are 99214 ($3M, 38.3%), 99213 ($2.5M, 31.8%), and 87428 ($370.6K, 4.8%), indicating that a few outpatient visit and respiratory testing codes dominate financial performance.

The code mix indicates a high-volume family medicine / outpatient primary care operation focused on established and new patient evaluation-and-management visits alongside point-of-care respiratory testing. The two highest-revenue codes are 99214 (45K claims, $66 avg paid/claim, $3M revenue) and 99213 (47.4K claims, $52 avg paid/claim, $2.5M revenue), which together reflect sustained throughput of routine and moderate-complexity office visits.

OGDEN CLINIC is a statewide outlier and a dominant provider for core office visit codes: 99214 ranks #6 of 1340 providers in-state (100th percentile; extreme outlier) and 99213 ranks #9 of 1355 providers in-state (99th percentile; extreme outlier). These rankings indicate the clinic operates at volumes far above typical state peers for primary care E/M services and is a major Medicaid primary-care access point in Utah.

The practice also shows outsized volume in respiratory and infectious-disease testing and in vaccination delivery compared with peers: 87428 ranks #1 of 46 providers in-state (100th percentile; extreme outlier), 87880 ranks #2 of 198 providers in-state (99th percentile; extreme outlier), and 90471 ranks #11 of 605 providers in-state (98th percentile; extreme outlier). High counts for 87428 (6.5K claims) and related PCR/antigen testing codes (e.g., U0002, 1.8K claims) suggest operational capacity for large-scale respiratory specimen testing and vaccine administration.

Preventive and pediatric well visits are a meaningful secondary line of service, supporting the family-medicine profile: 99391 ($321.1K, 4.1% of Medicaid revenue; ranks #14 of 218, 94th percentile) and 99392 ($260K, 3.4% of Medicaid revenue; ranks #11 of 194, 95th percentile), plus 99393 and 99394 volumes, indicate routine preventive care across age groups rather than a strictly adult-only practice. These codes point to an integrated panel that includes children and adolescents in addition to adults.

Laboratory, imaging, and ancillary services complement the clinic’s primary-care business but are not primary revenue drivers. Examples include general health panel 80050 ($65.1K; rank #17 of 51, 68th percentile), chest x-ray 71046 ($41.2K; rank #20 of 151, 87th percentile), and pelvic ultrasound 76856 ($29.8K; rank #21 of 48, 57th percentile), which together show routine in-office diagnostic support at typical-to-moderate volumes.

The NPI has long-standing tenure: enumerated on 2005-09-29 (~21 years ago). That sustained presence, combined with extremely high statewide ranks on core E/M and testing codes, supports the interpretation that OGDEN CLINIC PC is a well-established, Medicaid-focused family medicine practice with high patient throughput and operational emphasis on office visits, respiratory testing, and preventive care.

Medicaid: Complete Services Breakdown

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

160 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	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…	44,980	$70	$3M
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…	47,350	$50	$2.5M
87428	The lab analyst performs an immunoassay to qualitatively or semiquantitatively evaluate the patient specimen for antigens of severe acute respiratory syndrome (SARS) coronavirus, such as SARS–CoV–2…	6,500	$60	$370.6K
99203	The provider sees a new 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 provider…	6,160	$60	$369.6K
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…	4,060	$80	$321.1K
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…	3,380	$80	$260K
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…	2,320	$90	$199.4K
U0002	2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc	1,750	$70	$114K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,390	$60	$81.8K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	1,860	$40	$65.1K

Showing 1–10 of 160

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

Ogden Clinic PC — 9 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

160 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…	44	120	1,100	$30	$186.6K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	9	10	60	$1,680	$152.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	12	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…	6	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…	9	1,360	190	$70	$125K
95810	Polysomnography refers to the continuous and simultaneous monitoring and recording of various physiological and pathophysiological parameters of sleep for six or more hours with physician review,…	13	10	100	$430	$102.1K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	17	50	930	$60	$102.1K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	47	70	690	$30	$95.9K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	63	70	410	$50	$93.9K
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…	74	200	240	$90	$85.8K

Showing 1–10 of 160

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Carl Gray	UT	Hematology & Oncology Physician	$3.9M	$1.7M
Ogden Clinic Specialty Services LLC	UT	Sports Medicine (Family Medicine) Physician	$0	$1.7M
Chase Hansen	UT	Radiation Oncology Physician	$523.3K	$0
Andrew Coles	UT	Interventional Pain Medicine Physician	$389.6K	$120.9K
Chad Tingey	UT	Dermatology Physician	$491.3K	$0
Michael Hadley	UT	MOHS-Micrographic Surgery Physician	$383K	$0
John Hemmersmeier	UT	Family Medicine Physician	$382K	$0
Kelly Mikesell	UT	Medical Physician Assistant	$358.6K	$0
Jason Lance	UT	Diagnostic Radiology Physician	$251.9K	$2.9K
Aaron Stevenson	UT	Diagnostic Radiology Physician	$244.4K	$860

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$54.1M
Ivy Lane Pediatrics, LLC	UT	Home Health Agency	$0	$37M
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$5.1M
Utah Hematology Oncology PC	UT	Hematology & Oncology Physician	$0	$4.6M
Mt Ogden Utah Surgical Center LLC	UT	Ambulatory Surgical Clinic/Center	$1.2M	$1.3M
South Ogden Operations, LLC	UT	Assisted Living Facility	$0	$2.4M
Lisa Leishman	UT	Ophthalmology Physician	$1.6M	$419.9K
Sutton Clinical Services LLC	UT	Mental Health Counselor	$0	$1.8M
Alpine Home Medical Equipment LLC	UT	Oxygen Equipment & Supplies (DME)	$0	$1.6M
Claron Alldredge	UT	Ophthalmology Physician	$1.3M	$0

Ogden Clinic PC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References