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NPI 1790736122 · Provo, UT · Hematology & Oncology Physician
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Steven Wallentine is a hematology & oncology physician provider located in Provo, Utah. This profile covers 84 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 | Individual |
| Organization | Steven Wallentine |
| Address | 1055 N 500 W |
| City | Provo |
| State | UT |
| ZIP | 84604 |
| Taxonomy | Hematology & Oncology Physician |
| NPI Enumerated | May 12, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $1M |
| Medicaid | $7.6K |
Provider STEVEN WALLENTINE is effectively Medicare-centric by scale, reporting Total Medicare revenue of $1M versus Total Medicaid revenue of $7.6K; the provider’s Medicare activity drives the bulk of clinical revenue while Medicaid represents a very small share of billing. Precomputed concentration shows the top 3 Medicare codes account for 72.0% of Medicare revenue, and the top 3 Medicaid codes account for 100.0% of Medicaid revenue, highlighting a sharply skewed payer mix.
The code mix indicates an infusion- and biologic-focused practice consistent with a Hematology & Oncology specialty: high-revenue injectable codes include J0897 (denosumab), J9271 (pembrolizumab), and J3380 (vedolizumab), and multiple chemotherapy/infusion administration codes (for example 96413, 96365, 96402) appear in the top Medicare list. This pattern suggests the practice operates an on-site infusion/therapy delivery workflow rather than a purely office-visit outpatient clinic.
Revenue concentration at the code level is pronounced: J0897 accounts for $261.4K (27.1% of Medicare revenue), J9271 accounts for $249.4K (25.8%), and J3380 accounts for $183.7K (19.0%), and those three together are precomputed to represent 72.0% of this provider’s Total Medicare revenue. On the Medicaid side, 36415 ($4.9K, 63.4%), 80053 ($2.1K, 27.2%), and 85025 ($720, 9.4%) together make up 100.0% of Total Medicaid revenue, indicating Medicaid receipt is concentrated in basic lab and venipuncture services.
Competitive standing is mixed across the provider’s high-revenue Medicare codes: J0897 ranks #575 of 10057 (94th percentile) and is described as notably above typical national volume for this code, indicating a national-level high-volume position for denosumab administration. By contrast, J9271 ranks #1633 of 1841 (10th percentile) and J3380 ranks #211 of 620 (66th percentile), both labeled as typical, unremarkable volume for their codes, so the provider is not broadly dominant across all oncology biologics.
Operationally, several administration and infusion add-on codes are unusually prominent relative to peers: 96402 ranks #303 of 4765 (93th percentile) and is labeled notably above typical national volume for this code, while 96372 ranks #1522 of 58224 (97th percentile) and is also described as notably above typical national volume for this code. These high percentiles for administration codes reinforce that the practice’s revenue model relies heavily on in-office drug administration and related nursing/infusion throughput.
Medicaid activity is concentrated in routine lab and blood-draw services rather than biologic drug administration: Medicaid 36415 (venipuncture) is $4.9K (63.4% of Medicaid revenue) and ranks #100 of 236 in-state (58th percentile, typical, unremarkable volume), while Medicaid 80053 (CMP) is $2.1K (27.2%) and 85025 (CBC) is $720 (9.4%), both described as typical, unremarkable volumes in-state. This contrast with Medicare—where high-cost biologics drive revenue—suggests the provider bills Medicaid mainly for basic diagnostics and specimen collection rather than for high-cost infusion therapy.
Tenure in the market is long: the NPI was enumerated on 2006-05-12 (~20 years ago), indicating sustained presence and an established operating history in Provo, UT. That longevity, combined with concentrated Medicare biologic billing, may make this provider a stable target for payer clinical management or oncology drug-accounting strategies rather than a transient or new entrant.
For payer contracting and network oversight, the combination of concentrated Medicare revenue in a few high-cost injectable codes (top-3 = 72.0% of Medicare revenue) and very low Medicaid revenue ($7.6K total) suggests focused levers: drug acquisition/administration cost management and infusion-site utilization controls for Medicare lines, while Medicaid exposure appears limited to routine lab services. Given the provider’s high relative rank on specific administration and drug codes (for example J0897 notably above typical national volume), payers may prioritize review of contracting terms, drug reimbursement arrangements, or capacity planning for oncology infusion services rather than broad network changes.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
84 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| J0897 | Injection, denosumab, 1 mg | 14,520 | $20 | $261.4K |
| J9271 | Injection, pembrolizumab, 1 mg | 5,800 | $40 | $249.4K |
| J3380 | Injection, vedolizumab, intravenous, 1 mg | 10,810 | $20 | $183.7K |
| J3111 | Injection, romosozumab-aqqg, 1 mg | 7,350 | $10 | $58.8K |
| 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… | 450 | $90 | $38.6K |
| J9217 | Leuprolide acetate (for depot suspension), 7.5 mg | 220 | $130 | $29.3K |
| J1439 | Injection, ferric carboxymaltose, 1 mg | 26,250 | $1 | $26.3K |
| 96413 | Chemotherapy is a therapeutic procedure used for the treatment of cancer via the use of chemical agents. These chemical agents (drugs) work on the cancerous cells of the body to destroy them. These… | 220 | $90 | $19.3K |
| 96365 | The provider administers the initial intravenous infusion of a medication or other substance for a period up to one hour to prevent, treat, or diagnose a condition or disease. | 330 | $40 | $14.3K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 1,350 | $10 | $10.8K |
Showing 1–10 of 84
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 84 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
84 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| J9271 | 4 | 10 | 10,010 | $40 | $510.2K |
| J3111 | 4 | 10 | 9,770 | $10 | $149.8K |
| J3380 | 1 | 10 | 9,900 | $20 | $140.4K |
| J0897 | 4 | 70 | 1,920 | $20 | $67.2K |
| J9217 | 7 | 30 | 140 | $130 | $23.8K |
| J1439 | 4 | 20 | 15,750 | $1 | $17.5K |
| 96413 | 9 | 50 | 100 | $90 | $13.8K |
| 96401 | 7 | 20 | 140 | $50 | $13.7K |
| 99214 | 273 | 4,080 | 80 | $80 | $11.6K |
| 99215 | 486 | 1,190 | 40 | $110 | $7.5K |
Showing 1–10 of 84
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 |
|---|---|---|---|---|
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 350 | $10 | $4.9K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 100 | $20 | $2.1K |
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 180 | $1 | $720 |
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 |
|---|---|---|---|---|---|---|
| 85025 | A complete blood count (better known as a CBC) is a blood test request by a doctor that provides detailed information about various types of cells in a patient's blood. Usually a pathologist or a… | 89 | 120 | 1,100 | $30 | $186.6K |
| 36415 | In this procedure, the provider inserts a needle into a vein to collect a blood sample. | 100 | 240 | 220 | $50 | $145.2K |
| 80053 | The lab analyst performs a comprehensive metabolic panel, or CMP test in which he measures the blood level of 14 chemicals the code descriptor lists for the panel. | 88 | 100 | 2,770 | $10 | $75.1K |
Other providers in the same ZIP code as Steven Wallentine, ranked by combined Medicare and Medicaid revenue.
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