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 Valley Emergency Physicians Inc (NPI 1649204553)

Utah Valley Emergency Physicians Inc is a emergency medicine physician provider located in Provo, Utah. This profile covers 0 Medicare and 14 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 Valley Emergency Physicians Inc
Address	1034 North 500 West
City	Provo
State	UT
ZIP	84604
Taxonomy	Emergency Medicine Physician
NPI Enumerated	July 10, 2006

Payer Source	Total Paid
Medicaid	$4.7M
Medicare	$0

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

14 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.	29,110	$90	$2.7M
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.	20,060	$70	$1.5M
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…	1,720	$150	$255.7K
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.	4,510	$40	$185K
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…	180	$130	$23.5K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	5,150	$1	$20.6K
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…	160	$100	$15.1K
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…	100	$60	$6.5K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	50	$70	$3.4K
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	760	$1	$2.3K

Showing 1–10 of 14

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 Valley Emergency Physicians Inc — 1 of 10 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

14 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.	3	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.	13	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.	37	190	250	$40	$146.8K
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…	8	50	280	$140	$109.3K
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…	40	90	140	$90	$56K
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…	2	10	30	$130	$52.9K
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…	10	20	190	$40	$12.7K
93010	The provider interprets and reports on the results of a routine 12–lead (or more) electrocardiogram.	13	130	220	$10	$12K
12011	This CPT code is used for the simple repair of superficial wounds to the face, ears, eyelids, nose, lips, and/or mucous membranes, that are 2.5 cm or less in size.	11	10	130	$50	$8.7K
93042	The provider interprets a recording of the electrical conduction of the heart to examine any abnormality in its functioning using a maximum of three leads, wires that connect the recording device to…	3	10	760	$1	$5.2K

Showing 1–10 of 14

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Colorado West Emergency Physicians, LLC	CO	Emergency Medicine Physician	$0	$10.6M
Richard Sorensen	UT	Emergency Medicine Physician	$71.8K	$2.4K
Grant Rasmussen	UT	Family Medicine Physician	$28.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Revere Health PC	UT	Multi-Specialty Clinic/Center	$0	$24M
Utah Valley Pediatrics L.L.C.	UT	Pediatrics Physician	$0	$11.9M
Riverwoods Surgery Center, LLC	UT	Ambulatory Surgical Clinic/Center	$737.9K	$5M
Ryan Isom	UT	Retina Specialist (Ophthalmology) Physician	$3.7M	$0
Jack Stringham	UT	Retina Specialist (Ophthalmology) Physician	$3.4M	$0
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$3.3M
Richard Corey	UT	Retina Specialist (Ophthalmology) Physician	$3M	$50.1K
Provo City Board Of Education	UT	Local Education Agency (LEA)	$0	$3M
Robert Welch	UT	Retina Specialist (Ophthalmology) Physician	$2.5M	$0

Utah Valley Emergency Physicians Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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