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 Navajo Health System, Incorporated (NPI 1699803635)

Utah Navajo Health System, Incorporated is a family medicine physician provider located in Monument Valley, Utah. This profile covers 0 Medicare and 32 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 Navajo Health System, Incorporated
Address	30 West Medical Drive
City	Monument Valley
State	UT
ZIP	84536
Taxonomy	Family Medicine Physician
NPI Enumerated	March 1, 2007

Payer Source	Total Paid
Medicaid	$1.8M
Medicare	$0

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

32 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,250	$340	$763.1K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	930	$330	$302.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	400	$530	$214.7K
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…	330	$510	$167K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	180	$630	$113.3K
G0467	Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which…	1,820	$20	$36.4K
99000	Use this code for the in office preparation of a specimen for lab analysis and or its transport from the office to the outside testing laboratory.	250	$130	$31.5K
90656	This code represents a preservative–free trivalent influenza vaccine product containing split virus components. It is administered into the muscle in a 0.5 mL dosage.	80	$280	$22.3K
97161	The provider, typically a physical therapist, conducts a physical therapy evaluation that includes history to rule out any adverse factors that will affect care; observes whether the patient's…	30	$620	$21K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	360	$50	$16.3K

Showing 1–10 of 32

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 Navajo Health System, Incorporated — 0 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

32 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	368	370	690	$140	$704.2K
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…	104	120	1,100	$30	$186.6K
36415	In this procedure, the provider inserts a needle into a vein to collect a blood sample.	116	240	220	$50	$145.2K
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…	565	1,340	200	$80	$144K
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…	175	1,360	190	$70	$125K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	121	210	590	$50	$77.6K
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…	160	160	250	$50	$76.9K
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.	88	100	2,770	$10	$75.1K
97140	Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy…	36	110	320	$30	$51.8K
99212	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,…	50	170	80	$100	$35.2K

Showing 1–10 of 32

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Utah Navajo Health System, Incorporated	UT	Federally Qualified Health Center (FQHC)	$0	$55.1M
Utah Navajo Health System, Incorporated	UT	Family Medicine Physician	$0	$2.5M
Hanhngan Nguyen-tran	UT	General Practice Dentistry	$0	$656.9K
Manish Pandya	NM	Nephrology Physician	$227.3K	$470
Mahana Fisher	UT	Family Medicine Physician	$144.9K	$10.4K
Janelle Stewart	CO	Physician Assistant	$138.5K	$0
Anwar Tandar	UT	Interventional Cardiology Physician	$99.8K	$0
John Ryan	UT	Cardiovascular Disease Physician	$87.4K	$0
Richard Ward	UT	Physical Therapist	$76.6K	$0
Arlan Henrie	UT	Physical Medicine & Rehabilitation Physician	$76.5K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Wendell Key	UT	Family Medicine Physician	$11.4K	$2.1K
Ginger Snyder	UT	Medical Physician Assistant	$5.7K	$0

Utah Navajo Health System, Incorporated — Billing Profile & Reimbursement Data

Sign up for Utah Navajo Health System, Incorporated — Billing Profile & Reimbursement Data policy alerts

Utah Navajo Health System, Incorporated — Billing Profile & Reimbursement Data

Sign up for Utah Navajo Health System, Incorporated — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References