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NPI 1619091063 · Springville, UT · Internal Medicine Physician
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Steven Call is a internal medicine physician provider located in Springville, Utah. This profile covers 21 Medicare and 1 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Individual |
| Organization | Steven Call |
| Address | 771 W 450 S |
| City | Springville |
| State | UT |
| ZIP | 84663 |
| Taxonomy | Internal Medicine Physician |
| NPI Enumerated | March 19, 2007 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $895.3K |
| Medicaid | $2K |
Revenue is heavily concentrated in in-office biologic drug administrations: the top three Medicare codes (J3262, J0717, J1602) account for 76.9% of this provider's total Medicare revenue, with J3262 ($368.2K), J0717 ($228.8K) and J1602 ($119.5K) as the largest contributors. These are specific injectable biologics and suggest the practice generates most Medicare dollars from drug unit billing and supervised infusions rather than from high-volume office E/M alone.
Medicare claim volumes and low average paid-per-claim for the leading biologics point to unit-based drug billing: J3262 shows 73.6K claims at $5 avg paid/claim for $368.2K revenue, and J0717 shows 57.2K claims at $4 avg paid/claim for $228.8K revenue. Those counts, combined with the drug-focused revenue mix, reinforce that this operation bills many small drug units rather than fewer high-fee procedures.
Office visit E/M activity is a meaningful but secondary revenue stream in Medicare: 99214 produced $73K (7.8% of Medicare revenue) from 859 claims at $85 avg paid/claim, and it ranks notably above typical national volume for the code (97th percentile). This elevated 99214 ranking indicates the provider also delivers a higher-than-typical volume of moderate-complexity established-patient visits relative to national peers.
Medicaid billing is negligible compared with Medicare and concentrated entirely in office visits: the provider reported $2K total Medicaid revenue, all from 99214 (38 claims, $52 avg paid/claim), representing 100.0% of Medicaid revenue. With Medicaid rank at #1045 of 1340 in-state (22th percentile), the provider is a modest Medicaid participant and appears not to rely on Medicaid for its core drug/infusion activity.
Competitive standing for the top biologics is generally modest to typical rather than market-leading: J3262 ranks #116 of 618 nationally (81th percentile; typical, unremarkable volume), J0717 ranks #343 of 848 (59th percentile; typical) and J1602 ranks #569 of 1041 (45th percentile; typical). An exception is Q5119 (rituximab biosimilar) where the provider ranks #43 of 335 (87th percentile; typical), indicating a relatively higher concentration on that specific infused agent compared with peers.
Infusion and chemotherapy administration CPTs support an onsite infusion capability: 96365 (355 claims, $17K revenue), 96413 (115 claims, $11K revenue) and 96415 (157 claims, $3.3K revenue) appear on the Medicare top codes list, demonstrating that the practice performs initial and extended infusion services in addition to drug billing. These procedure codes align with the provider’s biologic-heavy revenue profile and imply operational capacity for supervised infusions.
The provider’s payer mix is effectively Medicare-dominant: lifetime Medicare revenue is $895.3K versus $2K in Medicaid, so the practice is functionally single-payer focused on Medicare. That imbalance suggests contract negotiations, capacity planning, and revenue risk will primarily be driven by Medicare policy and reimbursement for biologic administrations.
The provider has an established billing history with long tenure: NPI enumerated 2007-03-19 (~19 years ago), indicating nearly two decades of enrollment and an established billing footprint. Combined tenure and the concentrated biologic/infusion billing profile suggest a stable, specialized outpatient infusion/business model rather than a broad primary-care or high-Medicaid practice.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
21 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J3262 | Injection, tocilizumab, 1 mg | 73,640 | $10 | $368.2K |
| J0717 | Injection, certolizumab pegol, 1 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered) | 57,200 | $1 | $228.8K |
| J1602 | Injection, golimumab, 1 mg, for intravenous use | 11,950 | $10 | $119.5K |
| 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… | 860 | $90 | $73K |
| Q5119 | Injection, rituximab-pvvr, biosimilar, (ruxience), 10 mg | 3,300 | $20 | $72.6K |
| J0897 | Injection, denosumab, 1 mg | 1,020 | $20 | $18.4K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 360 | $50 | $17K |
| 96413 | Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These… | 120 | $100 | $11K |
| 76881 | In this procedure, the provider uses ultrasound to examine the complete joint for any defect or abnormality. The image appears in real time on a monitor, and a permanent image with interpretation is… | 120 | $40 | $4.5K |
| 96372 | A therapeutic, prophylactic, or diagnostic substance (a fluid, a drug, etc.) is injected via intramuscular or subcutaneous route into the patient's body. The procedure is performed by the physician… | 340 | $10 | $3.4K |
Showing 1–10 of 21
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 21 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
21 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J0717 | 6 | 10 | 57,900 | $1 | $388K |
| J3262 | 3 | 10 | 70,740 | $1 | $328K |
| J1602 | 3 | 10 | 11,950 | $10 | $127.5K |
| Q5119 | 2 | 10 | 3,700 | $20 | $84.2K |
| J0897 | 68 | 70 | 1,920 | $20 | $67.2K |
| 96413 | 23 | 50 | 100 | $90 | $13.8K |
| 99214 | 56 | 4,080 | 80 | $80 | $11.6K |
| 99213 | 2,790 | 3,680 | 60 | $50 | $6.4K |
| 96365 | 3 | 80 | 90 | $40 | $5.2K |
| 99205 | 244 | 460 | 20 | $140 | $4K |
Showing 1–10 of 21
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
1 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… | 40 | $50 | $2K |
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 1,045 | 1,340 | 200 | $80 | $144K |
Other providers in the same ZIP code as Steven Call, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Darren Chamberlain | UT | Pediatric Dentistry | $0 | $3M |
| Clear Horizons Clinical Services, LLC | UT | Mental Health Clinic/Center (Including Community Mental Health Center) | $0 | $1.3M |
| Scott Bower | UT | Pediatric Dentistry | $0 | $1M |
| Springville City Corporation | UT | Land Ambulance | $77.8K | $870.4K |
| South Valley Pediatric Dentistry | UT | Pediatric Dentistry | $0 | $894.5K |
| Hobble Creek Medical Clinic, LLC | UT | Pediatrics Physician | $0 | $753.8K |
| Senior Solutions Group Inc. | UT | Home Health Agency | $0 | $636.6K |
| Cascade Family Dental | UT | General Practice Dentistry | $0 | $523.1K |
| Numinus Wellness Ut Inc | UT | Psychiatry Physician | $0 | $384.4K |
| Springville Dermatology & Diagnostics PC | UT | Dermatopathology Physician | $0 | $368.8K |
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