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NPI 1881952315 · Draper, UT · Family Medicine Physician
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Spencer Hardenbrook is a family medicine physician provider located in Draper, Utah. This profile covers 11 Medicare and 1 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 | Spencer Hardenbrook |
| Address | 12176 S 1000 E |
| City | Draper |
| State | UT |
| ZIP | 84020 |
| Taxonomy | Family Medicine Physician |
| NPI Enumerated | May 3, 2012 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $965.5K |
| Medicaid | $3.7K |
This provider is overwhelmingly Medicare‑focused by revenue: lifetime Medicare revenue is $965.5K versus Medicaid revenue of $3.7K, so Medicare represents the vast majority of billed activity. The Medicaid footprint is negligible in scale compared with Medicare, making this effectively a single‑payer revenue profile for operational analysis.
Medicare revenue is extremely concentrated in a small set of codes: the precomputed top 3 Medicare codes account for 96.5% of total Medicare revenue. In particular one add‑on device code, Q4262, accounts for $864.3K of Medicare revenue (820 claims, $1054 avg paid/claim) and alone represents 89.5% of this provider's Medicare revenue, signaling a business model driven by a single procedure or product.
The procedure mix suggests a wound‑care and skin‑substitute service line anchored by device and advanced wound therapies: Q4262 (dual layer impax membrane), 97610 (low‑frequency ultrasound for wound healing, $26.5K revenue), and 15271 (skin substitute use, $7K revenue) appear among the top Medicare codes. This cluster of codes plus the strong dollar concentration on Q4262 points to a device‑oriented treatment pathway rather than broad primary‑care office revenue.
Evaluation-and-management activity is present but secondary to procedural/device revenue. Medicare 99214 contributes $40.5K (482 claims, $84 avg paid/claim) and Medicaid 99214 accounts for $3.7K (46 claims, $81 avg paid/claim), showing that routine clinic E/M visits exist in both payers but are small relative to device/procedure income.
Competitive standing for the largest Medicare procedure is modest nationally: Q4262 ranks #100 of 141 providers (29th percentile) and is described in the source as having typical, unremarkable volume for this code. Other Medicare codes tied to wound care and E/M (97610 rank #234 of 320, 26th percentile; G0439 rank #41577 of 105855, 60th percentile) are similarly characterized as typical or unremarkable, indicating this provider is not a dominant national player for these services despite high revenue concentration.
Within Medicaid the provider is not a major in‑state participant: the Medicaid revenue is entirely driven by 99214 (100.0% of Medicaid revenue) and that code ranks #980 of 1340 providers in‑state (27th percentile). This confirms a modest Medicaid presence concentrated in standard E/M visits rather than specialized procedural billing.
The NPI tenure is substantive—enumerated 2012-05-03 (~14 years ago)—which supports interpretation that this is an established practice with a sustained operational focus. The longevity combined with the concentrated code mix suggests a deliberate specialization rather than a transient billing pattern.
Although no codes are flagged as statistical outliers in the source data and volumes are labeled typical or unremarkable for the listed codes, the extreme revenue reliance on a single add‑on code (Q4262) creates a structural concentration risk: reimbursement policy or utilization changes affecting that code could materially alter the provider's revenue profile. Analysts should monitor device‑associated reimbursement trends and local competitive supply of wound‑care services as part of any payer contracting or utilization review work.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
11 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| Q4262 | Dual layer impax membrane, per square centimeter (add-on, list separately in addition to primary procedure) | 820 | $1,050 | $864.3K |
| 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… | 480 | $80 | $40.5K |
| 97610 | The provider uses a low–frequency ultrasound device to try to improve wound healing. | 80 | $320 | $26.5K |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 80 | $120 | $9.8K |
| 99310 | The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends… | 60 | $120 | $7.4K |
| 15271 | The provider uses a skin substitute, such as an allograft or xenograft, to cover wounds on the patient’s trunk, arms, and/or legs up to an area of 100 cm2. This code covers up to the first 25 cm2. | 60 | $120 | $7K |
| 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… | 60 | $60 | $3.8K |
| 99204 | The provider sees a new 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 provider… | 20 | $120 | $2.2K |
| 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… | 20 | $130 | $2K |
| 11000 | The provider uses surgical instruments to debride the dead tissue in skin for up to 10 percent of the body surface. | 30 | $40 | $1.4K |
Showing 1–10 of 11
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 11 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
11 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| Q4262 | 1 | 10 | 630 | $1,060 | $726K |
| 97610 | 5 | 10 | 100 | $310 | $41.1K |
| 99310 | 44 | 70 | 90 | $100 | $24.2K |
| 99214 | 232 | 4,080 | 80 | $80 | $11.6K |
| G0439 | 384 | 990 | 60 | $120 | $10.8K |
| 15271 | 13 | 20 | 80 | $100 | $9.1K |
| 99215 | 1,001 | 1,190 | 40 | $110 | $7.5K |
| 99213 | 1,814 | 3,680 | 60 | $50 | $6.4K |
| 99204 | 1,162 | 1,790 | 30 | $100 | $4.1K |
| 36415 | 523 | 870 | 50 | $10 | $1.6K |
Showing 1–10 of 11
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.
1 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… | 50 | $80 | $3.7K |
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
1 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average 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… | 980 | 1,340 | 200 | $80 | $144K |
Other providers in the same ZIP code as Spencer Hardenbrook, ranked by combined Medicare and Medicaid revenue.
| Provider | State | Taxonomy | Medicare Revenue | Medicaid Revenue |
|---|---|---|---|---|
| Beechtree Diagnostics LLP | UT | Clinical Medical Laboratory | $1M | $34.7M |
| Utah Case Management | UT | Case Management Agency | $0 | $13.3M |
| Lone Peak Hospital, Inc. | UT | General Acute Care Hospital | $0 | $4.1M |
| After Hours Medical LLC | UT | Urgent Care Clinic/Center | $0 | $3.2M |
| Rocky Mountain Laboratories LLC | UT | Clinical Medical Laboratory | $224.5K | $2.1M |
| Utnv Draper Operator, LLC | UT | Assisted Living Facility | $0 | $2.2M |
| Beechtree Molecular Lab LLC | UT | Clinical Medical Laboratory | $236.8K | $862.7K |
| Draper City | UT | Ambulance | $115.3K | $978.1K |
| Jeffrey Welch | UT | General Practice Dentistry | $0 | $856.8K |
| Utah Surgery Center LP | UT | Ambulatory Surgical Clinic/Center | $473.4K | $337.9K |
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