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 Cancer Specialists PC (NPI 1619925369)

Utah Cancer Specialists PC is a medical oncology physician provider located in Salt Lake City, Utah. This profile covers 0 Medicare and 35 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Utah Cancer Specialists PC
Address	3838 S 700 E Ste 100
City	Salt Lake City
State	UT
ZIP	84106
Taxonomy	Medical Oncology Physician
NPI Enumerated	May 5, 2006

Payer Source	Total Paid
Medicaid	$4.2M
Medicare	$0

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

35 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	8,970	$390	$3.5M
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…	4,430	$50	$225.8K
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…	1,430	$60	$83K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	770	$80	$61.9K
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…	1,330	$40	$51.9K
J0185	Injection, aprepitant, 1 mg	410	$120	$51.2K
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.	4,090	$10	$49.1K
96367	The provider administers an additional intravenous infusion or infusions, after an initial infusion, of a different medication or substance for a period up to one hour to prevent, treat, or diagnose…	1,170	$20	$24.5K
99205	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the provider…	210	$110	$23.3K
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.	540	$30	$15.6K

Showing 1–10 of 35

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 Cancer Specialists PC — 1 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

35 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
85025	A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a…	23	120	1,100	$30	$186.6K
J1453	Injection, fosaprepitant, 1 mg	4	10	40	$680	$149.8K
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…	94	1,340	200	$80	$144K
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.	27	40	1,280	$60	$128.4K
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…	243	1,360	190	$70	$125K
80050	The lab analyst performs testing for the specific group of clinical laboratory procedures in the general health panel. Payers typically consider 80050 to apply only when the clinician orders the…	47	50	930	$60	$102.1K
J1100	Injection, dexamethasone sodium phosphate, 1 mg	27	70	410	$50	$93.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	58	200	240	$90	$85.8K
J2469	Injection, palonosetron hcl, 25 mcg	3	10	350	$210	$83.3K
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…	54	160	250	$50	$76.9K

Showing 1–10 of 35

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Chase Hansen	UT	Radiation Oncology Physician	$523.3K	$0
William Nibley	UT	Medical Oncology Physician	$166K	$326K
James Clarke	UT	Radiation Oncology Physician	$491.6K	$0
Gregory Litton	UT	Medical Oncology Physician	$208.7K	$225.7K
Xylina Gregg	UT	Medical Oncology Physician	$412.9K	$0
James Shortridge	UT	Hematology & Oncology Physician	$221.4K	$177.5K
John Hayes	UT	Radiation Oncology Physician	$329.8K	$0
Thomas Skidmore	UT	Radiation Oncology Physician	$307.8K	$0
Nitin Chandramouli	UT	Medical Oncology Physician	$297.3K	$0
Nathan Rich	UT	Hematology & Oncology Physician	$248.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seventh Street Treatment Center	UT	Substance Abuse Rehabilitation Facility	$0	$7.4M
Touchstone Therapy Center Inc.	UT	Community/Behavioral Health Agency	$0	$4.7M
One- Eighty Out LLC	UT	Community/Behavioral Health Agency	$0	$4.4M
Apex Behavior Consulting LLC	UT	Behavior Analyst	$0	$2.5M
Ryan Leybas	UT	Clinical Social Worker	$28.7K	$1.2M
Brian Randle	UT	Dentist	$0	$1.1M
Omega Interventional Pain PLLC	UT	Pain Medicine Physician	$0	$667.6K
Access Private Duty, LLC	UT	In Home Supportive Care Agency	$0	$533K
Utnv East Millcreek, LLC	UT	Assisted Living Facility	$0	$528.9K
Millcreek Haven, LLC	UT	Assisted Living Facility	$0	$360.2K

Utah Cancer Specialists PC — Billing Profile & Reimbursement Data

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Utah Cancer Specialists PC — Billing Profile & Reimbursement Data

Sign up for Utah Cancer Specialists PC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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