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.

Michael Higgins (NPI 1780038141)

Field	Value
Entity Type	Individual
Organization	Michael Higgins
Address	1161 E Lorraine Dr
City	Salt Lake City
State	UT
ZIP	84106
Taxonomy	Clinical Social Worker
NPI Enumerated	April 21, 2016

Payer Source	Total Paid
Medicare	$3.7K
Medicaid	$0

Medicare: Complete Services Breakdown

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

3 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
96158	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	70	$30	$1.8K
96156	The provider assesses psychological, behavioral, emotional, cognitive, and social factors that affect a patient’s physical health, rather than assessing a specific mental health disorder. There are…	30	$40	$1.1K
96159	The provider, typically a psychologist, provides counseling and strategies for management of cognitive, emotional, social, cultural factors that impact management of a patient’s physical health…	80	$10	$810

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Utah Distribution

Michael Higgins — 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. state median

3 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
96158	5	10	60	$30	$2.7K
96156	3	10	20	$50	$950
96159	3	10	80	$10	$830

Related Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Utah Behavioral Health Services	UT	Psychiatry Physician	$0	$1.3M
University Of Utah Behavioral Health Services	UT	Psychiatry Physician	$0	$428.2K
Jennifer Griswold	UT	Psychiatric/Mental Health Nurse Practitioner	$64.9K	$0
Robert Frost	NM	Prescribing (Medical) Psychologist	$52.8K	$0
Pegah Afra	MA	Neurology Physician	$37.6K	$5.6K
Heather Jones	UT	Clinical Social Worker	$40.7K	$0
Daniela Solzbacher	UT	Psychiatry Physician	$31.3K	$0
Meghan Zorn	UT	Physician Assistant	$31K	$0
Kevin Walker	UT	Sleep Medicine (Psychiatry & Neurology) Physician	$26.2K	$0
Michael Voss	IL	Psychiatry Physician	$21.2K	$0

Nearby Providers

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

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Seventh Street Treatment Center	UT	Substance Abuse Rehabilitation Facility	$0	$7.4M
Touchstone Therapy Center Inc.	UT	Community/Behavioral Health Agency	$0	$4.7M
One- Eighty Out LLC	UT	Community/Behavioral Health Agency	$0	$4.4M
Utah Cancer Specialists PC	UT	Medical Oncology Physician	$0	$4.2M
Apex Behavior Consulting LLC	UT	Behavior Analyst	$0	$2.5M
Ryan Leybas	UT	Clinical Social Worker	$28.7K	$1.2M
Brian Randle	UT	Dentist	$0	$1.1M
Omega Interventional Pain PLLC	UT	Pain Medicine Physician	$0	$667.6K
Access Private Duty, LLC	UT	In Home Supportive Care Agency	$0	$533K
Utnv East Millcreek, LLC	UT	Assisted Living Facility	$0	$528.9K

Michael Higgins — Billing Profile & Reimbursement Data

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Michael Higgins — Billing Profile & Reimbursement Data

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Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References