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.

Ihc Health Services Inc (NPI 1922136126)

Ihc Health Services Inc is a pediatrics physician provider located in St George, Utah. This profile covers 0 Medicare and 44 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Ihc Health Services Inc
Address	1380 E Medical Center Dr
City	St George
State	UT
ZIP	84790
Taxonomy	Pediatrics Physician
NPI Enumerated	March 1, 2007

Payer Source	Total Paid
Medicaid	$2.1M
Medicare	$0

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

44 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…	14,070	$60	$801.9K
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…	4,890	$80	$396.1K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,620	$50	$244.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	8,980	$30	$242.4K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,760	$70	$187.9K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	1,630	$70	$105.8K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	550	$60	$32.9K
90472	This code represents each injection of a vaccine after the first; list this code in addition to the code for the first injection.	5,510	$1	$22K
87880	The analyst performs an immunoassay with direct optical, meaning visual, observation to detect Streptococcus, group A, in a patient sample, typically a throat swab.	470	$20	$8.9K
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…	60	$140	$7.8K

Showing 1–10 of 44

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

Ihc Health Services Inc — 3 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

44 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…	80	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…	29	1,360	190	$70	$125K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	12	220	200	$80	$74K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	13	190	150	$80	$58.1K
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…	149	270	80	$100	$41.6K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	36	50	250	$80	$40.9K
99203	The provider sees a new 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 provider…	221	290	100	$70	$37.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	11	150	60	$70	$32.2K
36416	In this procedure, the provider pricks the patient’s finger, heel, or ear with a pointed instrument and collects specimen of droplets of blood by pressing the pricking site.	43	70	290	$20	$27.5K
99460	The provider evaluates and manages the care of a normal newborn infant, typically immediately after birth, in a hospital or birthing center.	16	30	100	$90	$26.7K

Showing 1–10 of 44

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	Children's Hospital	$0	$129.5M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$68.7M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$65.8M
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$54.1M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$44.3M
Ihc Health Services Inc	UT	Home Infusion Therapy Pharmacy	$0	$38.1M
Ihc Health Services Inc	UT	Durable Medical Equipment & Medical Supplies	$0	$26.9M
Ihc Health Services Inc	UT	General Acute Care Hospital	$0	$25.3M
Ihc Health Services, Inc.	UT	Clinical Medical Laboratory	$2.7M	$17.9M
Ihc Health Services, Inc.	UT	General Acute Care Hospital	$0	$20.4M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Southwest Utah Community Health Center	UT	Federally Qualified Health Center (FQHC)	$0	$7.3M
Zion Eye Institute, Inc	UT	Ambulatory Surgical Clinic/Center	$6.1M	$19.7K
Summit Behavior Services	UT	Counselor	$0	$5.4M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$4.4M
Ron Lord	UT	Ophthalmology Physician	$3.2M	$0
Joshua Carlson	UT	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
St George Surgical Center LP	UT	Ambulatory Surgical Clinic/Center	$2.5M	$0
Coral Desert Surgery Center LLC	UT	Ambulatory Surgical Clinic/Center	$2.5M	$17.8K
Ihc Health Services Inc	UT	Clinical Medical Laboratory	$2.4M	$42.7K
Jerry D Twiggs Md PC	UT	Pediatric Adolescent Medicine Physician	$0	$2.2M

Ihc Health Services Inc — Billing Profile & Reimbursement Data

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Ihc Health Services Inc — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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