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.

University Of Utah Pediatric Services (NPI 1942664412)

Field	Value
Entity Type	Organization
Organization	University Of Utah Pediatric Services
Address	81 N Mario Capecchi Dr
City	Salt Lake City
State	UT
ZIP	84113
Taxonomy	Pediatric Cardiology Physician
NPI Enumerated	April 11, 2016

Payer Source	Total Paid
Medicaid	$2.2M
Medicare	$0

Medicaid: Complete Services Breakdown

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

29 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	10,360	$60	$621.4K
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…	3,830	$100	$398.7K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	4,480	$80	$335.7K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	3,570	$60	$225.2K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	610	$190	$112.1K
93320	The provider performs a complete Doppler echocardiography, which uses high–frequency sound waves to create a two–dimensional image of the heart, while the use of Doppler technology allows…	10,280	$10	$82.3K
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…	720	$110	$76.6K
93304	The provider performs a limited or follow–up transthoracic echocardiography to obtain images of the heart through the chest wall in patients born with heart defects. It is a limited examination of a…	1,850	$30	$63K
99205	The provider sees a new 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 provider…	350	$130	$46.2K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	20,290	$1	$40.6K

Showing 1–10 of 29

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

University Of Utah Pediatric Services — 7 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

29 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…	542	1,340	200	$80	$144K
93303	The provider performs a complete transthoracic echocardiography to obtain images of the heart structures through the chest wall in patients born with heart defects. This study includes visualization…	1	10	130	$80	$137.3K
99233	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	11	90	460	$50	$115K
93306	The provider uses transducers to obtain two–dimensional (2D) images of the heart structures through the chest wall. He evaluates the anatomy and function of all four heart chambers, valves, adjacent…	5	50	340	$80	$114K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	15	50	280	$140	$109.3K
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…	9	200	240	$90	$85.8K
93304	The provider performs a limited or follow–up transthoracic echocardiography to obtain images of the heart through the chest wall in patients born with heart defects. It is a limited examination of a…	1	10	30	$100	$68.4K
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	36	90	140	$90	$56K
93325	The provider performs Doppler echocardiography, a diagnostic procedure based on the Doppler effect of sound, color flow velocity mapping, a two–dimensional image representation of blood flow in the…	1	20	330	$30	$53.7K
99232	The 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…	50	100	200	$30	$53.5K

Showing 1–10 of 29

Related Providers

Other providers that share a Tax Identification Number (TIN) with University Of Utah Pediatric Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
University Of Utah Adult Services	UT	Ophthalmology Physician	$0	$3.1M
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$3.1M
Christopher Komanski	NC	Ophthalmology Physician	$2.3M	$0
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$1.6M
University Of Utah Pediatric Services	UT	Ophthalmology Physician	$0	$1.3M
University Of Utah Pediatric Services	UT	Child & Adolescent Psychiatry Physician	$0	$1.2M
University Of Utah Pediatric Services	UT	Hematology & Oncology Physician	$0	$925.3K
University Of Utah Pediatric Services	UT	Pediatric Otolaryngology Physician	$0	$843.3K
University Of Utah Pediatric Services	UT	Pediatric Orthopaedic Surgery Physician	$0	$829.4K
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$721.1K

Nearby Providers

Other providers in the same ZIP code as University Of Utah Pediatric Services, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ihc Health Services, Inc.	UT	Children's Hospital	$0	$129.5M
University Of Utah Pediatric Acuity Care	UT	Pediatric Emergency Medicine (Pediatrics) Physician	$0	$7.3M
University Of Utah Pediatric Acuity Care	UT	Neonatal-Perinatal Medicine Physician	$0	$3.3M
Ihc Health Services Inc	UT	Multi-Specialty Clinic/Center	$0	$2.4M
Ihc Health Services Inc	UT	Pediatric Radiology Physician	$0	$2M
Pediatric Anesthesiologists Inc	UT	Anesthesiology Physician	$0	$2M
University Of Utah Pediatric Acuity Care	UT	Pediatric Critical Care Medicine Physician	$0	$1.5M
Brett Packham	UT	Pediatric Dentistry	$0	$794K
University Of Utah Pediatric Services	UT	Pediatric Gastroenterology Physician	$0	$620.8K
University Of Utah Pediatric Services	UT	Pediatrics Physician	$0	$559K

University Of Utah Pediatric Services — Billing Profile & Reimbursement Data

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University Of Utah Pediatric Services — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References