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.

Grace Paradela (NPI 1588673826)

Field	Value
Entity Type	Individual
Organization	Grace Paradela
Address	292 S 1470 E Ste 200
City	Saint George
State	UT
ZIP	84790
Taxonomy	Internal Medicine Physician
NPI Enumerated	August 5, 2006

Payer Source	Total Paid
Medicare	$624.9K
Medicaid	$0

Key Findings

The provider’s revenue profile is driven by high-volume ambulatory E/M and preventive services: 99214 shows 3.4K claims and $272.5K revenue (45.1% of this provider's total Medicare revenue), G0439 shows 944 claims and $115.2K revenue (19.1%), and 99497 shows 659 claims and $51.4K revenue (8.5%). These three codes together account for 72.6% of this provider's total Medicare revenue, signaling an operation focused on established outpatient visits, annual wellness visits, and advance care planning rather than procedure-heavy specialties.

Revenue concentration is substantial — the precomputed top-3 share of 72.6% indicates that a small cluster of codes (99214, G0439, 99497) drives the majority of Medicare receipts. That concentration implies business sensitivity to changes in preventive care, E/M policies, or Medicare coverage rules affecting annual wellness visits and advance care planning.

The provider is effectively single-payer in the available data: Total Medicare revenue is $624.9K while there is no Medicaid billing on file. This means analyses of payer mix, access for dual-eligibles, or Medicaid-network positioning are limited because the practice does not bill Medicaid according to the records.

On competitive standing for core services the provider ranks at the top of national peer lists: 99214 ranks #158 of 479517 providers nationally (100th percentile; extreme outlier), G0439 ranks #28 of 105855 providers nationally (100th percentile; extreme outlier), and 99497 ranks #169 of 27157 providers nationally (99th percentile; extreme outlier). These ranks indicate unusually large national volumes for these specific Medicare codes, consistent with a dominant role in delivering AWVs, higher-level E/M visits, and billed advance care planning.

Care coordination and post-discharge services are a visible part of the practice mix: 99490 (301 claims, $13.8K) and transition codes 99496 (64 claims, $12.9K) and 99495 (40 claims, $5.7K) are present, with 99496 ranked #796 of 15461 providers nationally (95th percentile; typical, unremarkable volume) and 99490 at the 72th percentile. This pattern supports a service line that includes chronic care management and structured transitions of care alongside office-based visits.

The practice also provides home-based care and minor procedures: home visit codes 99349 (74 claims, $5.8K), 99350 (39 claims, $5.2K), and 99348 (67 claims, $3.4K) appear in the top codes, and procedure code 20553 has 127 claims and $5.5K revenue. While these codes are lower-revenue components individually, their presence demonstrates an operational breadth that includes in-home visits and musculoskeletal interventions.

Preventive screening, vaccination, and basic lab work form steady ancillary revenue streams: G0444 (927 claims, $15.8K; ranks #19 of 26377, 100th percentile; extreme outlier), influenza and flu vaccine administration codes such as G0008 (273 claims, $7.9K) and 90686 (274 claims, $6K), and lab panels like 80061 (763 claims, $9.9K) and 80053 (903 claims, $9K) appear consistently. High claim counts for screening and vaccines align with the heavy utilization of AWVs and primary care prevention services.

The provider has an established tenure in Medicare billing, with NPI enumeration dated 2006-08-05 (~20 years ago). Long enumeration combined with nationally extreme volumes on key preventive and E/M codes suggests a sustained, Medicare-centric practice model rather than a recent or transient billing pattern.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

46 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…	3,360	$80	$272.5K
G0439	Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	940	$120	$115.2K
99497	The provider discusses and shares planning with a patient, his family, or an individual representing the patient, regarding the future health care needs of the patient. Use this code for the first 30…	660	$80	$51.4K
G0444	Annual depression screening, 5 to 15 minutes	930	$20	$15.8K
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…	300	$50	$13.8K
99496	The provider manages the care of a patient during the transition to home care after discharge from a healthcare facility. The patient’s care requires high–level medical decision making, contact…	60	$200	$12.9K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	1,470	$10	$11.8K
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…	200	$50	$10.6K
80061	The lab analyst performs a lipid panel test in which he measures the blood level of cholesterol and fats called triglycerides in the blood.	760	$10	$9.9K
80053	The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel.	900	$10	$9K

Showing 1–10 of 46

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 46 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Grace Paradela — 13 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. state median

46 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99487	13	10	60	$110	$80.7K
99350	57	90	60	$120	$19.9K
99349	59	110	90	$80	$15K
99214	1	4,080	80	$80	$11.6K
G0439	1	990	60	$120	$10.8K
99215	468	1,190	40	$110	$7.5K
99490	12	80	80	$40	$7.4K
17000	112	270	130	$30	$6.8K
99496	5	60	20	$210	$6.6K
99213	567	3,680	60	$50	$6.4K

Showing 1–10 of 46

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Tyler Rencher	UT	Internal Medicine Physician	$123.7K	$0
William Caplin	UT	Nurse Practitioner	$34.2K	$0

Nearby Providers

Other providers in the same ZIP code as Grace Paradela, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Southwest Utah Community Health Center	UT	Federally Qualified Health Center (FQHC)	$0	$7.3M
Zion Eye Institute, Inc	UT	Ambulatory Surgical Clinic/Center	$6.1M	$19.7K
Summit Behavior Services	UT	Counselor	$0	$5.4M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$4.4M
Ron Lord	UT	Ophthalmology Physician	$3.2M	$0
Joshua Carlson	UT	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
St George Surgical Center LP	UT	Ambulatory Surgical Clinic/Center	$2.5M	$0
Coral Desert Surgery Center LLC	UT	Ambulatory Surgical Clinic/Center	$2.5M	$17.8K
Ihc Health Services Inc	UT	Clinical Medical Laboratory	$2.4M	$42.7K

Grace Paradela — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References