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NPI 1811991151 · Montezuma Creek, UT · Federally Qualified Health Center (FQHC)
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Utah Navajo Health System, Incorporated is a federally qualified health center (fqhc) provider located in Montezuma Creek, Utah. This profile covers 0 Medicare and 173 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 | Utah Navajo Health System, Incorporated |
| Address | 1478 East Highway 162 |
| City | Montezuma Creek |
| State | UT |
| ZIP | 84534 |
| Taxonomy | Federally Qualified Health Center (FQHC) |
| NPI Enumerated | June 1, 2005 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicaid | $55.1M |
| Medicare | $0 |
This provider is effectively a Medicaid-centered organization: it reports $55.1M in lifetime Medicaid revenue and has no Medicare billing on file, indicating a single-payer (Medicaid) operating footprint rather than a mixed Medicare/Medicaid panel. That payer concentration will shape revenue risk and contracting leverage toward Medicaid programs and managed-Medicaid plans.
Revenue is highly concentrated in a small set of outpatient and dental codes: the top 3 Medicaid codes (99213, 99214, D0220) account for 56.1% of this provider's total Medicaid revenue, led by 99213 at $19M (38.1% of Medicaid revenue). This concentration implies that office-based evaluation-and-management and basic dental imaging are the primary revenue drivers for the organization.
The mix of high-volume codes characterizes the operation as a multi-service FQHC offering primary care, dental, rehabilitative, behavioral health, and eye services: 99213 and 99214 dominate medical visits, D0220 and multiple dental procedure codes rank very highly, 97110/97140 indicate substantial physical therapy, 90837/90832 show psychotherapy services, and 92014/92012 reflect ophthalmology/exam activity. Together these lines suggest an integrated community health center model providing medical, dental, behavioral, and specialty outpatient services under one FQHC umbrella.
On competitive standing for core primary care visits, this provider is a dominant in-state player: 99213 ranks #8 of 1355 providers in-state (99th percentile; extreme outlier) with 48.6K claims and $392 avg paid/claim, while 99214 ranks #28 of 1340 (98th percentile). Those ranks and volumes place the organization among the top-tier Medicaid E/M providers in Utah by visit volume and revenue.
Dental service volumes are unusually high relative to peers, signaling a major dental care role in the community. D0220 is $4.4M (8.8% of Medicaid revenue) and ranks #6 of 436 (99th percentile; extreme outlier), D2150 is $959.6K (1.9%) and ranks #4 of 222 (99th percentile; extreme outlier), and D0274 ranks #2 of 389 (100th percentile; extreme outlier) — together these data show the provider is a state-level outlier in provision of dental diagnostics and procedures.
Physical therapy and rehabilitation are material service lines for this FQHC: 97110 generated $3.9M (7.9% of Medicaid revenue) and ranks #7 of 205 providers in-state (97th percentile; notably above typical), while 97140 produced $2.5M (4.9%) and ranks #4 of 110 (97th percentile; notably above typical). These figures indicate a sustained, above-average PT footprint rather than an ancillary or marginal rehab offering.
The provider also maintains significant population-health and preventive services capacity, evidenced by vaccine and chronic-disease education billing: 90686 shows $766.2K revenue and 90471 shows 9.4K claims ($562K), and G0108 (diabetes outpatient self-management) generated $396.2K while ranking #1 of 4 providers in-state (100th percentile). This pattern is consistent with an FQHC mission set prioritizing immunizations and chronic disease self-management for Medicaid populations.
The organization shows long tenure in the system with an NPI enumerated (registered) on 2005-06-01 (~21 years ago), supporting the interpretation of an established community clinic. Combined with $55.1M in Medicaid revenue and the absence of Medicare billing, the data suggest sustained focus on Medicaid-eligible populations and services tailored to that patient mix rather than Medicare-dominant specialties.
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.
173 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 48,570 | $390 | $19M |
| 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… | 12,810 | $360 | $4.6M |
| D0220 | Intraoral - periapical first radiographic image | 10,240 | $430 | $4.4M |
| 97110 | Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with… | 7,980 | $490 | $3.9M |
| 97140 | Manual therapy is a form of physical therapy which uses the controlled movement and pressure of hands to treat various disorders of soft tissues and joints, eg, chronic back pain. Manual therapy… | 12,010 | $210 | $2.5M |
| 99212 | The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a straightforward level of medical decision making,… | 7,040 | $320 | $2.2M |
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 3,620 | $470 | $1.7M |
| 92014 | An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group… | 3,450 | $470 | $1.6M |
| 92012 | For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any… | 2,440 | $410 | $1M |
| D2150 | Amalgam - two surfaces, primary or permanent | 4,510 | $210 | $959.6K |
Showing 1–10 of 173
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
173 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| 90837 | In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or… | 79 | 370 | 690 | $140 | $704.2K |
| 90853 | Group psychotherapy is provided to a group of people who are normally not acquainted with each other but might be sharing similar kinds of psychological issues. The psychotherapist selects a group of… | 114 | 150 | 1,060 | $70 | $528.1K |
| 90834 | In 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… | 55 | 110 | 270 | $120 | $439.4K |
| T1015 | Clinic visit/encounter, all-inclusive | 33 | 70 | 270 | $110 | $376.1K |
| 90791 | In this service, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. | 99 | 140 | 160 | $220 | $374.1K |
| 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. | 93 | 190 | 200 | $50 | $239.5K |
| 90832 | In 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… | 32 | 90 | 270 | $70 | $200.4K |
| 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… | 27 | 120 | 1,100 | $30 | $186.6K |
| D0120 | Periodic oral evaluation - established patient | 22 | 470 | 460 | $80 | $149.8K |
| 99283 | The 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. | 80 | 190 | 250 | $40 | $146.8K |
Showing 1–10 of 173
Other providers in the same ZIP code as Utah Navajo Health System, Incorporated, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Utah Navajo Health System, Incorporated | UT | Non-emergency Medical Transport (VAN) | $0 | $15.7M |
| Jesse Moses | UT | Physician Assistant | $9.9K | $0 |
| Alan Wygant | UT | Family Nurse Practitioner | $2.6K | $0 |
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