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.

Emergency Physicians Integrated Care, LLC (NPI 1578598199)

Key Findings

Field	Value
Entity Type	Organization
Organization	Emergency Physicians Integrated Care, LLC
Address	1050 E South Temple
City	Salt Lake City
State	UT
ZIP	84102
Taxonomy	Emergency Medicine Physician
NPI Enumerated	July 12, 2006

Payer Source	Total Paid
Medicaid	$31.2M
Medicare	$0

EMERGENCY PHYSICIANS INTEGRATED CARE, LLC is effectively a Medicaid-focused emergency medicine practice: it has no Medicare billing on file and reports $31.2M in lifetime Medicaid revenue. The absence of Medicare activity makes this provider functionally single-payer in the available claims dataset, concentrating analytic attention on Medicaid patterns and in-state competition.

Revenue is highly concentrated in three emergency department E/M codes: 99285, 99284, and 99283 together account for 96.3% of the provider's total Medicaid revenue. Individually, 99285 generates $16.5M (52.9%), 99284 generates $10.5M (33.6%), and 99283 generates $3.1M (9.9%), indicating that the business is overwhelmingly driven by ED evaluation-and-management encounters at a mix of high, moderate, and low acuity.

The code mix and volumes point to a high-throughput emergency department coverage model: extremely large counts for 99285 (173.9K claims), 99284 (139.8K claims), and 99283 (67.2K claims) indicate constant ED patient flow across acuity levels. The presence of critical care codes 99291 (5.5K claims, $734.7K revenue) and 99292 (184 claims) further supports that clinicians provide higher-intensity/critical care services in addition to standard ED E/M care.

This provider is a statewide volume leader for core ED services: it ranks #1 in-state for 99285, 99284, and 99283 and is described as an "extreme outlier" or "far above typical state volume" for those codes (100th percentile where reported). That ranking establishes the entity as a dominant Medicaid ED biller in Utah for high-, moderate-, and low-acuity E/M services rather than a modest or marginal participant.

Critical care activity is notable though more limited by revenue share: 99291 contributes $734.7K (2.4% of Medicaid revenue) and ranks #2 of 54 providers in-state (98th percentile; extreme outlier), indicating meaningful but smaller-scale critical care reporting relative to the ED E/M codes. The presence and rank of 99291/99292 suggest capability to manage critically ill patients in the ED setting rather than exclusively low-acuity urgent care.

Operationally relevant ancillary patterns include very high volumes of ECG interpretation (93010: 43.2K claims, $129.5K revenue) and frequent overnight-service entries (99053: 2K claims, $0 revenue), both ranked among the top in-state and labeled as extreme outliers. Low per-claim payment for some ancillary services (e.g., 93010 at $3 avg paid/claim) combined with huge claim counts is consistent with ED workflows that document many brief diagnostic and facility-oriented services.

Several procedure codes tied to common ED procedures—simple wound repairs (12001, 12002, 12011), incision and drainage (10060, 10061), and airway management (31500)—appear at volumes described as "notably above typical state volume" or otherwise elevated versus peers. These patterns reinforce that the provider's clinical mix centers on front-line emergency procedures rather than elective or longitudinal outpatient services.

The provider has established longevity in the registry, with NPI enumeration dated 2006-07-12 (~20 years ago), which combined with the concentration of Medicaid revenue and top-state rankings, suggests a long-standing operational presence in Utah's emergency care market. For payers and competitors, the profile signals a high-volume ED billing partner with dominant Medicaid market share for core emergency E/M codes and ancillary ED services.

Medicaid: Complete Services Breakdown

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

27 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	173,940	$100	$16.5M
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.	139,750	$80	$10.5M
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.	67,200	$50	$3.1M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	5,480	$130	$734.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	43,160	$1	$129.5K
12001	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.5 cm or less in…	1,060	$50	$56K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	670	$70	$43.6K
10061	The provider incises the area of abscess and drains the collection of pus, such as those related to a carbuncle, hidradenitis, cyst, furuncle, or paronychia, with the help of surgical instruments. A…	320	$120	$36.7K
12002	This CPT code is used for the simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities (including the hands and feet) that are 2.6 to 7.5 cm in…	610	$60	$35.8K
29125	The provider applies a static, or rigid, splint to the lower arm extending from the elbow to the palm to immobilize an injury to the forearm or wrist during healing or for stabilization of a fracture…	400	$40	$15.5K

Showing 1–10 of 27

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

Emergency Physicians Integrated Care, LLC — 10 of 24 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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.	1	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.	1	190	200	$50	$239.5K
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.	1	190	250	$40	$146.8K
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…	501	1,360	190	$70	$125K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2	50	280	$140	$109.3K
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	36	70	530	$50	$68.5K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	52	90	140	$90	$56K
99236	The provider sees a patient for hospital inpatient or observation care involving evaluation and management (E/M), with an admission encounter and discharge encounter on the same date. The E/M…	4	10	30	$130	$52.9K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	83	170	80	$100	$35.2K
99292	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	2	10	70	$120	$32.1K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Cydney Mortensen	UT	Physician Assistant	$281K	$0
Jason Crook	UT	Nurse Practitioner	$177.8K	$0
Cody Peterson	ID	Emergency Medicine Physician	$62K	$0
Matthew Griggs	ID	Emergency Medical Services (Emergency Medicine) Physician	$59.5K	$0
Scott Cross	ID	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$59.5K	$0
Justin Thompson	ID	Emergency Medicine Physician	$58.7K	$0
Douglas Cook	ID	Emergency Medicine Physician	$58.2K	$0
Jennifer Ross	UT	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	$44.8K	$0
Jeffrey Rosenberg	WY	Emergency Medicine Physician	$39K	$0
Charles Sherwood	ID	Physician Assistant	$30.8K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Helping Hand Association	UT	Substance Abuse Rehabilitation Facility	$0	$18.4M
House Of Hope	UT	Substance Abuse Rehabilitation Facility	$0	$11.6M
Odyssey House Inc	UT	Family Medicine Physician	$0	$10.1M
Salt Lake Regional Medical Center LP	UT	General Acute Care Hospital	$0	$9.8M
Lyssa Inc	UT	Ambulatory Surgical Clinic/Center	$0	$7.2M
First Step House	UT	Clinical Medical Laboratory	$0	$2.3M
Planned Parenthood Association Of Utah	UT	Voluntary or Charitable Agency	$0	$1.4M
University Of Utah Behavioral Health Services	UT	Psychiatry Physician	$0	$1.3M
S-h Opco Salt Lake City, LLC	UT	Assisted Living Facility	$0	$879.2K
Ihc Health Services Inc	UT	Internal Medicine Physician	$0	$854K

Emergency Physicians Integrated Care, LLC — Billing Profile & Reimbursement Data

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Emergency Physicians Integrated Care, LLC — 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