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    OpenPayerNPI Medicare & MedicaidUt Medical Group Inc
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    Ut Medical Group Inc — Billing Profile & Reimbursement Data

    NPI 1780676650 · Memphis, TN · Multi-Specialty Clinic/Center

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    Ut Medical Group Inc is a multi-specialty clinic/center provider located in Memphis, Tennessee. This profile covers 0 Medicare and 228 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationUt Medical Group Inc
    Address1068 Cresthaven Rd Ste 300
    CityMemphis
    StateTN
    ZIP38119
    TaxonomyMulti-Specialty Clinic/Center
    NPI EnumeratedAugust 17, 2005

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

    Payer SourceTotal Paid
    Medicaid$53.1M
    Medicare$0

    Key Findings

    UT MEDICAL GROUP INC reports no Medicare billing on file and $53.1M in lifetime Medicaid revenue, making its Medicare presence effectively nil and its financial exposure concentrated in Medicaid contracts and patients. This payer mix indicates the organization operates as a predominantly Medicaid-facing provider rather than a dual-payor practice.

    Revenue is highly concentrated: the precomputed top three Medicaid codes account for 62.5% of the provider's total Medicaid revenue, led by 99472 at $21.7M (43.7%), followed by 99469 at $4.8M (9.6%) and 99479 at $4.6M (9.2%). This concentration means a small set of neonatal/newborn critical-care codes drive the majority of billing and financial risk.

    The code mix points to a dominant neonatal and newborn intensive-care service line: 99472 (follow up care of a critically ill infant) is the single largest revenue driver at $21.7M, and companion codes 99469 and 99479 (newborn/neonatal critical care and low birth weight infant care) contribute materially. Together these codes and their high volumes are consistent with a substantial NICU and newborn critical-care operation rather than a general outpatient-only practice.

    Competitive standing in-state is strong for neonatal services: 99472 ranks #1 of 11 providers in Tennessee (100th percentile; notably above typical state volume) and 99479 ranks #2 of 19 (94th percentile; notably above typical state volume). These ranks indicate UT MEDICAL GROUP is a leading, high-volume provider of neonatal critical-care services within the state.

    Beyond neonatology, the group shows a meaningful dialysis/ESRD footprint: 90960 (monthly ESRD management, 4+ visits) has 17.7K claims and $953.3K revenue (1.9%), 90961 (monthly ESRD management, 2–3 visits) is $357K (0.7%) and ranks #1 of 41 (100th percentile; extreme outlier), and 90935 (hemodialysis) appears with $161.4K and ranks #1 of 40 (100th percentile; extreme outlier). These items suggest the provider also manages substantial chronic dialysis activity alongside its neonatal caseload.

    Ambulatory evaluation-and-management volumes are unusually large: 99213 (70.9K claims, $2.6M, 5.3%) and 99214 (65.5K claims, $3.1M, 6.3%) both rank in the 99th percentile statewide, with 99213 described as an "extreme outlier, far above typical state volume." This pattern signals a high-throughput outpatient clinic component handling many established-patient visits in addition to specialty inpatient services.

    Several specialty procedure codes are marked as extreme or notable outliers, underscoring concentrated specialties beyond general E/M: 90961, 90935, 36902, and 92012 each rank at or near the top of in-state lists (many at 100th percentile), while codes like 99238 and 99232 are also in very high percentiles. The presence of multiple 97–100th percentile and "extreme outlier" labels indicates the provider is a large, atypically high-volume participant in multiple discrete service lines within Tennessee.

    UT MEDICAL GROUP's NPI was enumerated on 2005-08-17 (~21 years ago), reflecting a long-tenured presence in the market. Coupled with the concentrated Medicaid revenue and high statewide ranks on neonatal, dialysis, ophthalmology, and high-volume E/M codes, this tenure suggests an established, specialized regional provider whose business operations are heavily weighted to Medicaid-funded neonatal and select specialty services.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    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

    Medicaid: Complete Services Breakdown

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

    228 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99472The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.65,910$330$21.7M
    99469The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.15,530$310$4.8M
    99479The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.44,300$100$4.6M
    99480The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.47,220$90$4.4M
    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…65,490$50$3.1M
    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…70,950$40$2.6M
    99238The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends 30 minutes or less on the service on the…17,080$60$973.4K
    90960The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…17,650$50$953.3K
    99232The 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…43,390$20$867.8K
    99460The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.12,280$70$822.8K

    Showing 1–10 of 228

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

    How this provider's Medicaid billing volume and revenue compare to other Tennessee providers billing the same CPT/HCPCS codes.

    Full comparison — all codes billed, vs. Tennessee median

    228 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    99472The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.1101,110$340$3.6M
    99469The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.4201,380$300$2.7M
    99480The provider directs the care of a recovering low birth weight infant, whose current weight is between 2501 and 5000 grams.2101,710$90$1M
    99479The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.220890$100$997K
    99283The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.539610570$110$884.4K
    H0016Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)57130620$200$655.5K
    U0003Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…11100400$60$524.7K
    90834In this service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient. The treatment session with the patient typically lasts for anywhere…276360350$50$414.4K
    J0178Injection, aflibercept, 1 mg51040$570$363.4K
    43775Using laparoscopic technique, the provider reduces the size of the stomach by removing the bulk of the stomach in a vertical fashion. This procedure leaves a long, cylindrical stomach without the…51080$960$314K

    Showing 1–10 of 228

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Ut Medical Group Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Stephen HuddlestonTNRetina Specialist (Ophthalmology) Physician$5.7M$0
    Salar RafieetaryTNRetina Specialist (Ophthalmology) Physician$2.1M$0
    Pawan RawalTNNeurology Physician$1.3M$0
    Steve CharlesTNRetina Specialist (Ophthalmology) Physician$769.6K$0
    Tulio BertoriniTNNeurology Physician$733K$0
    Rami KhouzamSCInterventional Cardiology Physician$292.1K$0
    Benjamin KingTNOphthalmology Physician$251.4K$0
    Asif KazmiARNephrology Physician$209K$0
    Brian JerkinsTNOphthalmology Physician$191.4K$0
    Adam ThomasINUrology Physician$178.1K$0

    Nearby Providers

    Other providers in the same ZIP code as Ut Medical Group Inc, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Amisub (sfh), Inc.TNGeneral Acute Care Hospital$0$20.2M
    Maxim Healthcare Services, Inc.TNHome Health Agency$0$18.5M
    Mid-south Maternal Fetal Medicine PCTNMaternal & Fetal Medicine Physician$0$8.1M
    Elect Home Care, LLCTNIn Home Supportive Care Agency$0$7.6M
    First Choice Community Services, IncTNIn Home Supportive Care Agency$0$7.5M
    Tennessee Emergency Physicians, PLLCTNEmergency Medicine Physician$0$6.3M
    Dar Salud Care PLLCTNFamily Medicine Physician$0$5.2M
    Silver Angels Of Tennessee - Shelby, LLCTNIn Home Supportive Care Agency$0$5.1M
    Abundant Care LLCTNIn Home Supportive Care Agency$0$4.1M
    Obstetrics And Medicine PLLCTNObstetrics Physician$0$4M

    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.

    Medicaid Revenue by Year vs. Tennessee Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Tennessee Distribution
    Ut Medical Group Inc — 17 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Tennessee