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.

Utah Emergency Physicians (NPI 1588048979)

Key Findings

Field	Value
Entity Type	Organization
Organization	Utah Emergency Physicians
Address	5121 S Cottonwood St
City	Salt Lake City
State	UT
ZIP	84107
Taxonomy	Emergency Medicine Physician
NPI Enumerated	July 15, 2015

Payer Source	Total Paid
Medicaid	$14.5M
Medicare	$0

This provider is effectively a Medicaid-centric emergency practice: Total Medicare revenue is none (no Medicare billing on file) while Total Medicaid revenue is $14.5M, indicating the entity’s billed and recorded payer activity is concentrated in Medicaid. The absence of Medicare billing suggests analysts should treat this profile as a single-payer (Medicaid) population for competitive and utilization comparisons.

Revenue is highly concentrated in a small set of ED E/M codes: the precomputed top 3 Medicaid codes by revenue account for 88.9% of the provider’s total Medicaid revenue. Those top drivers are 99285 ($7.4M; 51.0% of Medicaid revenue), 99284 ($4.6M; 31.5% of Medicaid revenue), and 99283 ($922.3K; 6.3% of Medicaid revenue), which together produce the majority of reported Medicaid receipts.

The code mix reflects a high-volume emergency department operation that leans toward higher-acuity care. 99285 and 99284 are the two largest revenue contributors (78.1K and 61.9K claims respectively) and relate to moderate-to-high level ED evaluation and management services, while 99283 also contributes materially; this pattern is consistent with continuous ED throughput handling a broad range of acuity.

State competitive standing for high-acuity ED services is dominant: 99285 ranks #2 of 155 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code) and 99284 ranks #2 of 192 providers in-state (99th percentile; extreme outlier, far above typical state volume for this code). 99283 also ranks highly at #8 of 186 providers in-state (96th percentile; notably above typical state volume), confirming the provider is an outlier in Utah on multiple core ED metrics.

Critical care and inpatient/observation activity are notable beyond routine ED visits. 99291 (critical care) produced $741.9K (5.1% of Medicaid revenue) with a rank of #3 of 54 providers in-state (96th percentile; extreme outlier), and inpatient/observation codes such as 99223 ($355.2K; #3 of 87, 98th percentile) and 99236 ($233.9K; #1 of 5, 100th percentile) indicate meaningful engagement in higher-intensity, hospital-based care.

Procedure and ancillary service mix is consistent with ED functional scope: high-volume ECG interpretation (93010: 31.9K claims, $63.8K revenue, #4 of 129 providers in-state, 98th percentile) plus procedural codes for abscess drainage (10061, 10060) and wound repair (12001, 12011) demonstrate routine provision of both diagnostic monitoring and common emergency procedures. These ancillary revenues are small relative to ED E/M but reflect typical emergency department service breadth.

Operational and payer-risk implication: because 88.9% of Medicaid revenue comes from three ED E/M codes, the provider’s revenue is sensitive to changes in ED visit volumes, case-mix, or Medicaid reimbursement policy for high-acuity ED services. That concentration increases exposure to shifts in Medicaid policy or local referral patterns while also indicating clear negotiating leverage when contracting for emergency services in-state.

The organization has an established presence: NPI enumerated on 2015-07-15 (~11 years ago), suggesting multi-year operational stability in the market. Combined with the large state-level ranks and persistent high-acuity volumes, the tenure supports the view of a mature, Medicaid-focused emergency practice rather than a new or transitory operation.

Medicaid: Complete Services Breakdown

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

24 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.	78,070	$100	$7.4M
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.	61,850	$70	$4.6M
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.	20,960	$40	$922.3K
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…	4,980	$150	$741.9K
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…	3,900	$90	$355.2K
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…	1,770	$130	$233.9K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	31,890	$1	$63.8K
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…	1,090	$40	$47K
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…	360	$110	$39.6K
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…	530	$60	$30.6K

Showing 1–10 of 24

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

Utah Emergency Physicians — 9 of 23 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

24 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.	2	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.	2	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.	8	190	250	$40	$146.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	61	90	460	$50	$115K
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…	3	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.	45	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…	3	90	140	$90	$56K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	69	100	200	$30	$53.5K
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…	1	10	30	$130	$52.9K
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…	3	10	70	$120	$32.1K

Showing 1–10 of 24

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$11.6M
Matthew Ashton	UT	Emergency Medicine Physician	$80.5K	$7K
Alisa Fujihashi	AR	Emergency Medicine Physician	$58.4K	$0
Cabe Clark	UT	Emergency Medicine Physician	$41.1K	$13.2K
James Price	UT	Emergency Medicine Physician	$42.6K	$2.3K
Tyson Cook	UT	Emergency Medicine Physician	$39.9K	$2.7K
Mitchell Barneck	UT	Emergency Medicine Physician	$42.2K	$0
Kaytelin Suslavich	UT	Emergency Medicine Physician	$33.4K	$0
Brian Smith	UT	Emergency Medicine Physician	$32.3K	$0
James Villareal	AZ	Emergency Medicine Physician	$32.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$68.7M
Ihc Health Services, Inc.	UT	Clinical Medical Laboratory	$2.7M	$17.9M
Alpine Home Medical Equipment LLC	UT	Oxygen Equipment & Supplies (DME)	$0	$18.6M
Ddi Vantage	UT	Developmentally Disabled Services Day Training Agency	$0	$18.4M
Home Caregivers Partnership, LLC	UT	Home Health Agency	$0	$10.4M
Gcs Foundation	UT	Supports Brokerage Agency	$0	$6.2M
Ihc Health Services Inc	UT	Diagnostic Radiology Physician	$0	$6.1M
Joel Herring	UT	Retina Specialist (Ophthalmology) Physician	$5.6M	$23.7K
Project Reality	UT	Mental Health Counselor	$0	$5.1M
Caregiver Support Network, Inc	UT	Home Health Agency	$0	$5M

Utah Emergency Physicians — Billing Profile & Reimbursement Data

Sign up for Utah Emergency Physicians — Billing Profile & Reimbursement Data policy alerts

Utah Emergency Physicians — Billing Profile & Reimbursement Data

Sign up for Utah Emergency Physicians — Billing Profile & Reimbursement Data policy alerts

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