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 (NPI 1588656870)

Field	Value
Entity Type	Organization
Organization	University Of Utah
Address	50 N Medical Dr
City	Salt Lake City
State	UT
ZIP	84132
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 22, 2005

Payer Source	Total Paid
Medicaid	$221.3M
Medicare	$0

Key Findings

UNIVERSITY OF UTAH reports no Medicare billing on file and is effectively a Medicaid-centered billing entity, with total Medicaid revenue of $221.3M. The absence of Medicare revenue suggests payer mix is dominated by state programs rather than traditional federal fee-for-service Medicare for this NPI.

Revenue is highly concentrated: the top three Medicaid codes (G0463, 8888888, J3490) together represent 59.4% of the provider's Medicaid revenue. Individually, G0463 accounts for $43.8M (25.4%), 8888888 accounts for $42.8M (24.8%), and J3490 accounts for $15.9M (9.2%), indicating a small number of codes drive most of reported Medicaid receipts.

The code mix indicates a large outpatient and procedure-driven operation: G0463 (hospital outpatient clinic visit for assessment and management) is the single largest Medicaid revenue driver at $43.8M and 894.3K claims, while high-volume lab and specimen codes such as 36415 (190.9K claims, $13.7M) and C9803 (70.6K claims, $6.6M) point to very high outpatient testing and collection throughput. The presence of many injectable drug codes (J3490, J1100, J0690, J2704, J1885, J2250, etc.) further suggests substantial on-site medication administration and infusion or procedural services within the outpatient setting.

Competitive standing within Utah is dominant for many major service lines: G0463 ranks #1 of 28 providers in-state (100th percentile; extreme outlier) and 8888888 ranks #1 of 57 providers in-state (100th percentile; extreme outlier), demonstrating that this provider far outpaces state peers in outpatient clinic visit volume and the unidentified high-volume code. Numerous other codes—J3490, 36415, J0690, J1885, Q9967, J2250 and more—also appear at the 100th percentile or near it, underscoring a statewide leadership position across lab, drug, and ancillary outpatient services.

Several codes are flagged as statistical outliers by the underlying comparisons, which is notable for operational monitoring: labels in the data include "extreme outlier" for multiple high-revenue codes (e.g., G0463, 8888888, J3490, 36415) and "notably above typical" for others (e.g., C9803, J2704). These designations indicate routine volumes or paid amounts that are far above typical state peers rather than small, routine contributions.

There is notable reliance on injectable and high-cost drug administrations in Medicaid revenue: J3490 (unclassified drugs) reports $15.9M and ranks #1 of 32 providers in-state (100th percentile), and specific injectable drugs such as J0690, J2704, J1885, J2250, and J2930 each contribute materially to the $221.3M total. This pattern suggests clinical operations with substantial procedural or infusion activity and a material pharmacy/drug administration component to outpatient billing.

Operational concentration risk is evident given that two codes alone—G0463 and 8888888—together make up roughly half of the Medicaid revenue (25.4% and 24.8% respectively). Such dependence on a very small set of high-volume codes means changes in reimbursement policy, coding rules, or patient mix for those services could have outsized effects on the provider's Medicaid revenue.

The provider has an established presence: NPI enumeration date is 2005-08-22 (~21 years ago), indicating long-term participation in the billing environment and potential institutional scale that aligns with its statewide leadership on many Medicaid codes. A few items show limited peer context (for example, A9576 ranks #1 of 1 providers in-state with a 0th percentile note), which suggests some codes are unique or uncommon in the state dataset and require separate contextual review.

Medicaid: Complete Services Breakdown

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

891 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	894,330	$50	$43.8M
8888888	N/A	175,320	$240	$42.8M
J3490	Unclassified drugs	165,490	$100	$15.9M
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	190,870	$70	$13.7M
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	70,580	$90	$6.6M
J8499	Prescription drug, oral, non chemotherapeutic, nos	102,200	$60	$6.2M
J1100	Injection, dexamethasone sodium phosphate, 1 mg	19,430	$250	$4.9M
J0690	Injection, cefazolin sodium, 500 mg	10,190	$470	$4.7M
J2704	Injection, propofol, 10 mg	16,340	$210	$3.4M
J1885	Injection, ketorolac tromethamine, per 15 mg	22,440	$140	$3.2M

Showing 1–10 of 891

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 — 21 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

891 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
8888888	N/A	1	60	8,900	$400	$9.5M
J8499	Prescription drug, oral, non chemotherapeutic, nos	1	10	52,700	$60	$3.1M
A9576	Injection, gadoteridol, (prohance multipack), per ml	1	10	7,160	$380	$2.8M
A0431	Ambulance service, conventional air services, transport, one way (rotary wing)	3	10	1,050	$1,320	$1.6M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	1	30	1,760	$50	$1.6M
41899	Use this code to report a procedure on the teeth and adjoining alveolar structures for which there is no specific code available.	11	20	630	$750	$1.2M
C9803	Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source	1	10	2,100	$90	$1.1M
A0430	Ambulance service, conventional air services, transport, one way (fixed wing)	5	10	450	$1,330	$855.7K
A0435	Fixed wing air mileage, per statute mile	5	10	460	$1,220	$796.5K
A0436	Rotary wing air mileage, per statute mile	3	10	1,060	$610	$773.1K

Showing 1–10 of 891

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
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	Ophthalmology Physician	$0	$3.1M
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$3.1M
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 — 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