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NPI 1730798372 · St George, UT · Clinical Medical Laboratory
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Ihc Health Services Inc is a clinical medical laboratory provider located in St George, Utah. This profile covers 4 Medicare and 3 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Ihc Health Services Inc |
| Address | 600 S Medical Center Dr |
| City | St George |
| State | UT |
| ZIP | 84790 |
| Taxonomy | Clinical Medical Laboratory |
| NPI Enumerated | July 29, 2020 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $2.4M |
| Medicaid | $42.7K |
This entity is heavily Medicare-focused in scale: lifetime Medicare revenue is $2.4M compared with $42.7K from Medicaid, so Medicare dominates the revenue base and the provider functions effectively as a Medicare-centric laboratory. The provider’s NPI was enumerated on 2020-07-29 (~6 years ago), indicating a relatively recent entry into the billing ecosystem.
Business mix aligns with a clinical molecular pathology laboratory: the top billed services are molecular pathology and genomic panel codes (81479 and 81450), with supporting pathology/immunohistochemistry work (88360) and pharmacogenomic testing (81418). The dominance of 81479 suggests the operation is structured around molecular diagnostic procedures that do not fit more specific codes, while 88360 activity indicates in-house or closely affiliated histology/IHC processing and interpretation.
Medicare revenue is extremely concentrated: the precomputed top-3 Medicare codes account for 99.5% of this provider's total Medicare revenue, and a single code, 81479, alone represents 94.8% of Medicare revenue ($2.3M). This concentration implies material business risk if utilization patterns, coding rules, or payer coverage for that code change.
Medicaid billing shows a similar concentration pattern: the precomputed top-3 Medicaid codes account for 100.0% of the provider's total Medicaid revenue, with 81479 responsible for 97.8% of Medicaid revenue ($41.4K). Such payer-specific concentration means Medicaid exposure is essentially the same service mix as Medicare but at a much smaller scale.
Competitive standing by code is mixed across payers: for Medicare, 81479 ranks #20 of 80 nationally (76th percentile) and is described as 'typical, unremarkable volume,' indicating a mid-to-upper placement nationally for that code rather than market dominance. By contrast, 88360 is only a small share of Medicare revenue (2.2% , $54.6K) but ranks #63 of 5330 nationally (99th percentile), suggesting the provider processes a high absolute count of immunohistochemistry stains relative to many peers despite that code representing a small revenue share.
State-level Medicaid positioning is limited but concentrated: 81479 ranks #2 of 4 in-state (67th percentile) and accounts for almost all Medicaid revenue, while 88360 ranks #3 of 4 (33rd percentile) with a minor Medicaid revenue contribution ($940). Notably, 81418 shows 243 Medicaid claims with $0 avg paid/claim and $0 revenue and is listed as #1 of 1 in-state with a 0th percentile note, indicating either non-covered services, denied payments, or reporting idiosyncrasies for that code at the state level.
Payments per claim differ substantially across payers for the same procedure: Medicare paid $3012 avg paid/claim for 81479 (765 claims, $2.3M revenue) while Medicaid paid $52 avg paid/claim for 81479 (797 claims, $41.4K revenue), reflecting large payer price differentials for the provider’s primary molecular pathology work. These per-claim payment disparities underscore that revenue concentration on 81479 exposes the provider to payer-specific reimbursement variability.
Given the concentration metrics and the mix of high-revenue molecular codes plus supporting pathology services, the provider’s strategic position is that of a specialized molecular diagnostics lab with modest geographic footprint: reasonably established nationally on select tests but not broadly diversified by payer or procedure. The combination of a recent NPI (2020-07-29) and heavy reliance on a small set of codes suggests monitoring for changes in utilization, coding specificity, or reimbursement policy is warranted.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 770 | $3,010 | $2.3M |
| 81450 | The lab analyst performs a genomic sequence analysis panel to evaluate the patient specimen, such as blood or bone marrow, for DNA and possibly RNA alterations in five to 50 genes known to impact… | 80 | $740 | $58K |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 620 | $90 | $54.6K |
| 81418 | Code 81418 describes a test to evaluate a blood or saliva specimen for changes in at least six genes that may impact metabolism of many therapeutic drugs. The test must include CYP2C19 and CYP2D6… | 30 | $490 | $12.7K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 4 CPT/HCPCS codes.
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
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 |
|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 800 | $50 | $41.4K |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 50 | $20 | $940 |
| 81418 | Code 81418 describes a test to evaluate a blood or saliva specimen for changes in at least six genes that may impact metabolism of many therapeutic drugs. The test must include CYP2C19 and CYP2D6… | 240 | $0 | $0 |
How this provider's Medicaid billing volume and revenue compare to other Utah providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Utah median
3 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 81479 | Use 81479 to report a molecular pathology procedure that does not have a specific code. | 2 | 10 | 550 | $130 | $2.8M |
| 88360 | The lab analyst applies a single antibody stain on a slide or slides prepared from a single patient specimen, such as tumor tissue. Then a qualified provider, typically a pathologist, evaluates the… | 3 | 10 | 60 | $40 | $2.8K |
| 81418 | Code 81418 describes a test to evaluate a blood or saliva specimen for changes in at least six genes that may impact metabolism of many therapeutic drugs. The test must include CYP2C19 and CYP2D6… | 1 | 10 | 240 | $0 | $0 |
Other providers in the same ZIP code as Ihc Health Services Inc, ranked by combined Medicare and Medicaid revenue.
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