Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidJames Craig
    Ask Trek AI about this page

    James Craig — Billing Profile & Reimbursement Data

    NPI 1730474792 · Salt Lake City, UT · Urology Physician

    Customize your policy alerts

    Sign up for James Craig — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    James Craig is a urology physician provider located in Salt Lake City, Utah. This profile covers 12 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.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeIndividual
    OrganizationJames Craig
    Address4252 S Highland Dr Ste 200
    CitySalt Lake City
    StateUT
    ZIP84124
    TaxonomyUrology Physician
    NPI EnumeratedJune 17, 2011

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

    Payer SourceTotal Paid
    Medicare$56K
    Medicaid$0

    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.

    12 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    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…200$70$13K
    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…120$100$11K
    52000In this procedure, the provider performs an examination of the interior of the bladder, the urethra, and the ureteric openings by means of a cystourethroscope, a thin flexible or rigid tube with a…40$170$7.6K
    52356The provider performs a cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into…20$310$7.2K
    99204The provider sees a new 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 provider…60$110$5.9K
    99222The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…30$100$3.1K
    99203The provider sees a new 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 provider…40$80$2.9K
    52332The provider performs cystourethroscopy, the inspection of the interior of the bladder, the urethra, prostatic urethra, and ureteric openings using a cystoscope passed through the urethra and into…30$90$2.3K
    99284The 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.10$90$960
    51798Providers perform this ultrasound to measure the volume of residual urine in the bladder.120$10$920

    Showing 1–10 of 12

    Medicare: Competitive Analysis & Benchmarks

    How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 12 CPT/HCPCS codes.

    View: State1 / 2

    Full comparison — all codes billed, vs. state median

    12 rows

    CPT/HCPCS CodeRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    52000436060$150$12.6K
    992141,5224,08080$80$11.6K
    5235693020$480$10.1K
    992135473,68060$50$6.4K
    9928448149050$80$5.2K
    992043411,79030$100$4.1K
    52332103020$180$4K
    9922219957020$90$3.4K
    992034631,36030$70$2.7K
    51798338090$10$960

    Showing 1–10 of 12

    Related Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Granger Medical Clinic PCUTMulti-Specialty Clinic/Center$0$5.1M
    Douglas MehrUTRetina Specialist (Ophthalmology) Physician$2.7M$0
    Mary Jane PenningtonUTPediatrics Physician$729.8K$15K
    Neal KhuranaSDVascular & Interventional Radiology Physician$704.3K$0
    Granger Medical Specialists LLCUTClinic/Center$0$618K
    Douglas HeinerUTProcedural Dermatology Physician$530K$0
    Todd RandolphARAnatomic Pathology & Clinical Pathology Physician$405.5K$0
    Craig DavisUTInterventional Pain Medicine Physician$272.9K$0
    Michael HinckleyUTDermatology Physician$249.9K$0
    Stewart LandauUTUrology Physician$243.7K$0

    Nearby Providers

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

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Northern Utah Healthcare CorporationUTGeneral Acute Care Hospital$0$35.7M
    Nomi Health Inc.UTClinical Medical Laboratory$108.9K$9.1M
    Valley Mental Health IncorporatedUTPhysical Disabilities Residential Treatment Facility$0$5M
    ValleylabUTClinical Medical Laboratory$0$2.7M
    Utah Healthcare Institute IncUTFamily Medicine Physician$0$1.9M
    Valley Mental Health IncorporatedUTHome Health Registered Nurse$0$1.3M
    Creek Capital East Gate LLCUTPediatric Dentistry$0$570.9K
    Wasatch Endoscopy Center LtdUTAmbulatory Surgical Clinic/Center$486.9K$62.1K
    St Marks Ambulatory Surgery Associates LPUTAmbulatory Surgical Clinic/Center$512.1K$0
    Adult Care Clinic IncUTAcute Care Nurse Practitioner$0$474.8K

    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
    James Craig — 0 of 12 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Utah