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    OpenPayerNPI Medicare & MedicaidJustin Mansfield
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    Justin Mansfield — Billing Profile & Reimbursement Data

    NPI 1699707059 · Ogden, UT · Internal Medicine Physician

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    Justin Mansfield is a internal medicine physician provider located in Ogden, Utah. This profile covers 67 Medicare and 0 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJustin Mansfield
    Address4403 Harrison Blvd
    CityOgden
    StateUT
    ZIP84403
    TaxonomyInternal Medicine Physician
    NPI EnumeratedJuly 7, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicare$716.3K
    Medicaid$0

    Key Findings

    Provider profile and tenure: JUSTIN MANSFIELD is an Internal Medicine Physician whose NPI was enumerated on 2006-07-07 (~20 years ago), indicating long-standing Medicare enrollment and potential continuity in the local referral network and billing patterns. The provider’s lifetime Medicare revenue totals $716.3K, reflecting a modest-sized Medicare practice over the enrollment period.

    Payer mix and scale: this provider is effectively single-payer in these records — total Medicare revenue is $716.3K and there is no Medicaid billing on file. The absence of Medicaid activity suggests operations and revenue are driven almost entirely by Medicare beneficiaries rather than dual-eligibles or state-managed programs.

    Revenue concentration: the top three Medicare codes account for a concentrated share of Medicare receipts — the precomputed top-3 share is 47.8% of total Medicare revenue. The highest-revenue individual codes are 99350 ($152.6K, 22.4%), 99349 ($113.6K, 16.7%), and 99214 ($58.5K, 8.6%), indicating a small set of service lines drive nearly half of Medicare dollars received.

    Business/service-line implications — home-based care and complex office visits: the dominant codes 99350 and 99349 (home/residence E/M visits for established patients) combined with 99345/99344/99348 among the top items point to a practice model that delivers significant home-based primary care. The presence of high-volume office E/M 99214 and higher-complexity visits 99215 further indicates a mix of in-office chronic disease management alongside substantial house-call activity.

    Preventive and transitional care emphasis: high-volume annual wellness visits G0439 ($56.6K, 8.3%) and initial AWVs G0438 ($12.8K, 1.9%), together with transitional care codes 99496 ($17.3K, 2.5%) and 99495 ($11.4K, 1.7%), show the practice performs both prevention-focused visits and structured post-discharge management. These code patterns suggest an operational focus on continuity of care and Medicare-driven quality touchpoints that align with value-oriented outpatient management.

    Remote monitoring and digital care delivery: multiple remote physiologic monitoring codes appear among the top billings — 99458 ($28.1K, 4.1%), 99457 ($14K, 2.1%), and 99454 ($16.5K, 2.4%) — indicating an established RPM program with sizable monthly activity. Rank percentiles for these codes are in the typical-to-notable range (for example 99458 ranks in the 92nd percentile nationally), which supports the view that remote monitoring is an integrated part of the care model rather than an occasional service.

    Competitive standing and statistical outliers: this provider is a clear national outlier on several home-visit and wellness codes — 99350 ranks #120 of 7304 providers (98th percentile; extreme outlier) and G0439 ranks #959 of 105855 providers (99th percentile; extreme outlier), indicating far above-typical national volume for those services. Other codes like 99349 (97th percentile; notably above typical) and 99496 (97th percentile; notably above typical) further underline a competitive position nationally for home-based E/M and certain transitional care services, while many laboratory and routine office E/M codes sit at more typical percentiles.

    Service mix nuance — high-volume injectables and routine labs with different competitive signals: the practice reports 1.4K claims for J0897 (denosumab) generating $24.8K but ranks in the 21st percentile nationally, indicating substantial absolute claim counts locally but modest standing versus national peers for that drug claim. Common diagnostic and lab panels (82306, 84443, 83036, 80061, 80053) appear throughout the top-25 with routine revenue shares and typical-to-high percentiles, consistent with ancillary testing performed as part of chronic disease management rather than as dominant revenue drivers.

    Medicare: Total Revenue Breakdown by CPT/HCPCS Code

    Medicare revenue breakdown by CPT/HCPCS procedure code.

    View: Bar Chart1 / 2

    Medicare: Complete Services Breakdown

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

    67 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99350The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves high medical decision making or the provider spends at least 60…1,170$130$152.6K
    99349The provider sees an established patient for a home or residence visit involving evaluation and management (E/M). The visit involves moderate medical decision making or the provider spends at least…1,220$90$113.6K
    99214The 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…690$90$58.5K
    G0439Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit460$120$56.6K
    G0181Physician or allowed practitioner supervision of a patient receiving medicare-covered services provided by a participating home health agency (patient not present) requiring complex and…420$80$31.5K
    99458The provider manages treatment using data from remote physiologic monitoring. The service requires at least one real–time interactive communication with the patient or caregiver during the month.…970$30$28.1K
    99345The provider sees a new patient for a home or residence visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends at least 75…210$130$27.1K
    J0897Injection, denosumab, 1 mg1,380$20$24.8K
    99213The 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…430$50$23.2K
    99215The 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…160$130$20.7K

    Showing 1–10 of 67

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 67 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    67 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    J089757701,920$20$67.2K
    99458620220$30$24.9K
    9935029060$120$19.9K
    99349311090$80$15K
    G018132060$70$12.6K
    99457630130$30$11.7K
    992141034,08080$80$11.6K
    77067109120150$50$11.5K
    G04391099060$120$10.8K
    9945444080$30$8K

    Showing 1–10 of 67

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Tanner Memorial ClinicUTInternal Medicine Physician$0$8.1M
    Hussayn BoumelhemNVFamily Nurse Practitioner$1.1M$0
    Gregory AustadUTRheumatology Physician$963.9K$0
    Andrew ColesUTInterventional Pain Medicine Physician$389.6K$120.9K
    Laurence NelsonUTOphthalmology Physician$367.8K$0
    Michael MartineauUTDermatology Physician$323.3K$0
    Glen BiddulphUTInternal Medicine Physician$214.4K$0
    Upinder SinghNVGeriatric Medicine (Internal Medicine) Physician$180.9K$0
    Tyler WilliamsUTInternal Medicine Physician$179.2K$0
    David StevensUTOrthopaedic Surgery Physician$160.6K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Ihc Health Services IncUTGeneral Acute Care Hospital$0$54.1M
    Ivy Lane Pediatrics, LLCUTHome Health Agency$0$37M
    Ogden Clinic PCUTFamily Medicine Physician$0$8.3M
    Ihc Health Services IncUTDurable Medical Equipment & Medical Supplies$0$5.1M
    Utah Hematology Oncology PCUTHematology & Oncology Physician$0$4.6M
    Mt Ogden Utah Surgical Center LLCUTAmbulatory Surgical Clinic/Center$1.2M$1.3M
    South Ogden Operations, LLCUTAssisted Living Facility$0$2.4M
    Lisa LeishmanUTOphthalmology Physician$1.6M$419.9K
    Sutton Clinical Services LLCUTMental Health Counselor$0$1.8M
    Ogden Clinic Specialty Services LLCUTSports Medicine (Family Medicine) Physician$0$1.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicare Revenue by CPT/HCPCS Code
    Claims Volume vs. Utah Distribution
    Justin Mansfield — 13 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Utah