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.

Evolve Emod LLC (NPI 1699182212)

Field	Value
Entity Type	Organization
Organization	Evolve Emod LLC
Address	5965 S 900 E Ste 255
City	Salt Lake City
State	UT
ZIP	84121
Taxonomy	Home Modifications Contractor
NPI Enumerated	July 15, 2014

Payer Source	Total Paid
Medicaid	$23.9M
Medicare	$0

Key Findings

EVOLVE EMOD LLC is registered as a Home Modifications Contractor in SALT LAKE CITY, UT with its NPI enumerated on 2014-07-15 (~12 years ago). The entity has no Medicare billing on file and reports $23.9M in lifetime Medicaid revenue, indicating an operational focus on Medicaid-funded services rather than Medicare-driven work.

Medicaid revenue is extremely concentrated: the provider's top three Medicaid codes account for 100.0% of its total Medicaid revenue, with S5165 alone generating $23.4M (97.9% of Medicaid revenue) across 12.3K claims at an average paid amount of $1899 per claim. This concentration indicates that virtually all billed activity and reimbursement are tied to a single service line.

The code mix underscores a primary business model centered on home modifications: S5165 (Home modifications; per service) dominates revenue, while G9006 (Coordinated care fee, home monitoring) and A9999 (Miscellaneous DME supply or accessory, not otherwise specified) appear as much smaller adjunct services. Together these codes suggest the operation provides physical home modification work as its core offering, with care coordination and occasional DME items billed alongside those modification services.

Payer mix is effectively single-payer: there is no Medicare revenue on file, and Medicaid accounts for the provider's entire reported lifetime revenue ($23.9M). Analysts should treat this entity as Medicaid-dependent for revenue exposure and comparative analyses.

Competitive standing for the primary codes shows the provider occupying a sole or leading role in-state for its largest services: S5165 and G9006 both rank #1 of 1 providers in-state (0th percentile; no state peer volume comparison available), meaning this provider is the only in-state reporter for those codes in the available dataset. Because no state peer volume comparison is available for those codes, benchmarks against other in-state providers are not possible for the dominant services.

For A9999 the provider ranks #2 of 3 providers in-state (50th percentile; typical, unremarkable volume for this code) and that code contributes just $104.5K (0.4% of Medicaid revenue) over 143 claims at $731 avg paid/claim. This indicates limited participation in miscellaneous DME relative to the small in-state peer group and confirms A9999 is not a material revenue driver.

Operational and reimbursement dynamics are uneven across billed services: S5165 carries a high average paid per claim ($1899), G9006 pays at a much lower average ($147), and A9999 averages $731 per claim. This disparity in per-claim reimbursement highlights that the provider's financial performance is driven by high-value modification services rather than by volume of lower-paid codes.

The dependence on a single code for nearly all revenue creates both strategic visibility and concentration risk: with 97.9% of Medicaid revenue tied to S5165 and the top three codes totaling 100.0%, any policy, coverage, or pricing change affecting S5165 could materially affect the provider's revenue profile. Analysts should flag this high concentration when assessing contracting, reimbursement negotiations, or program-level vulnerability.

Medicaid: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
S5165	Home modifications; per service	12,320	$1,900	$23.4M
G9006	Coordinated care fee, home monitoring	2,700	$150	$396.9K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	140	$730	$104.5K

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

Evolve Emod LLC — 0 of 3 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

3 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
S5165	Home modifications; per service	1	10	12,320	$1,900	$23.4M
G9006	Coordinated care fee, home monitoring	1	10	2,700	$150	$396.5K
A9999	Miscellaneous dme supply or accessory, not otherwise specified	2	10	140	$180	$37.8K

Nearby Providers

Other providers in the same ZIP code as Evolve Emod LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Land Rehabilitation LLC	UT	Physical Therapist	$0	$4M
Rosewood Assisted Care Inc	UT	Assisted Living Facility	$0	$3.2M
Bristol Hospice - Utah Ii, L.L.C.	UT	Community Based Hospice Care Agency	$0	$2.6M
Journey Treatment Center	UT	Substance Abuse Rehabilitation Facility	$0	$1.9M
Douglas Toole	UT	Foot & Ankle Surgery Podiatrist	$1.6M	$0
Big Smiles Utah P.C.	UT	Dentist	$0	$1.3M
J Q Medical Supply, LLC	UT	Durable Medical Equipment & Medical Supplies	$0	$1.2M
Transport Connection, Inc	UT	Private Vehicle	$0	$806.7K
Innovation Medical Group PC	UT	Podiatrist	$0	$741.2K
Utah Gastroenterology LLC	UT	Gastroenterology Physician	$0	$613.8K

Evolve Emod LLC — Billing Profile & Reimbursement Data

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Evolve Emod LLC — 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

Nearby Providers

Frequently Asked Questions

References