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.

University Of Utah Specialty Services (NPI 1780088849)

Field	Value
Entity Type	Organization
Organization	University Of Utah Specialty Services
Address	50 N Medical Dr
City	Salt Lake City
State	UT
ZIP	84132
Taxonomy	Maternal & Fetal Medicine Physician
NPI Enumerated	October 20, 2014

Payer Source	Total Paid
Medicaid	$1.4M
Medicare	$0

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	2,940	$90	$267.6K
59025	In this procedure, the provider measures the fetal heart rate of the fetus in response to its own movements.	9,080	$20	$172.4K
99215	The 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…	1,230	$120	$152.3K
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…	1,840	$80	$140K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	1,320	$90	$113.8K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	1,180	$70	$83.6K
99490	The clinical staff provides services directed by the provider to support and coordinate a patient’s care across multiple disciplines. The patient has two or more chronic conditions that place the…	1,740	$40	$60.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1,100	$50	$55K
76816	The provider reexamines the fetus to follow up on a prior abnormal transabdominal ultrasound.	2,350	$20	$51.7K
76805	In this procedure, the provider performs an ultrasound of a pregnant uterus for examination of the first or a single fetus and to examine the mother after the first trimester, or more than 14 weeks…	1,270	$40	$48.3K

Showing 1–10 of 29

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

University Of Utah Specialty Services — 2 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

29 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99284	The 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.	95	190	200	$50	$239.5K
59400	In this global service, the provider and nonphysician healthcare providers in the practice provide all of the antepartum care, admission to the hospital for delivery, labor management, including…	10	10	60	$1,680	$152.9K
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…	144	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…	209	1,360	190	$70	$125K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	26	90	460	$50	$115K
99215	The 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…	37	200	240	$90	$85.8K
59409	In this procedure, the provider provides admission to the hospital for delivery, labor management, including induction of labor, fetal monitoring, use of low forceps, and episiotomy, vaginal delivery…	2	10	30	$1,330	$57.2K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	63	90	140	$90	$56K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	24	100	200	$30	$53.5K
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	2	20	170	$120	$51.9K

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Of Utah Specialty Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Utah Specialty Services	UT	Physical Medicine & Rehabilitation Physician	$0	$1.1M
Steven Edgley	UT	Physical Medicine & Rehabilitation Physician	$123.6K	$0
William Spiker	UT	Orthopaedic Surgery of the Spine Physician	$119.8K	$0
Christopher Duncan	UT	Physical Medicine & Rehabilitation Physician	$115.3K	$0
Keith Cummings	WA	Sports Medicine (Physical Medicine & Rehabilitation) Physician	$114.1K	$0
Tyler Clark	MT	Physical Medicine & Rehabilitation Physician	$108.1K	$0
Yvonne Hsu	UT	Gynecology Physician	$84.2K	$0
Scott Evans	CO	Diagnostic Radiology Physician	$80.6K	$0
Arlan Henrie	UT	Physical Medicine & Rehabilitation Physician	$76.5K	$0
Graham Wagner	NH	Physical Medicine & Rehabilitation Physician	$69.8K	$0

Nearby Providers

Other providers in the same ZIP code as University Of Utah Specialty Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Utah	UT	General Acute Care Hospital	$0	$221.3M
University Of Utah Adult Services	UT	Emergency Medicine Physician	$0	$6.9M
University Of Utah Adult Services	UT	Diagnostic Radiology Physician	$0	$4M
University Of Utah Adult Services	UT	Internal Medicine Physician	$0	$3.5M
University Of Utah Adult Services	UT	Ophthalmology Physician	$0	$3.1M
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$3.1M
University Of Utah Adult Services	UT	Anesthesiology Physician	$0	$3M
Dermatology Division University Of Utah Medical Center	UT	Dermatology Physician	$0	$1.4M
University Of Utah Adult Services	UT	Cardiovascular Disease Physician	$0	$1.2M
University Of Utah Adult Services	UT	Anatomic Pathology & Clinical Pathology Physician	$0	$1.1M

University Of Utah Specialty Services — Billing Profile & Reimbursement Data

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University Of Utah Specialty Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References