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 Colorado for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Colorado 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. Colorado (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 Physicians Incorporated (NPI 1962461889)

Key Findings

Field	Value
Entity Type	Organization
Organization	University Physicians Incorporated
Address	12605 E 16th Ave
City	Aurora
State	CO
ZIP	80045
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 20, 2006

Payer Source	Total Paid
Medicaid	$190.8M
Medicare	$0

UNIVERSITY PHYSICIANS INCORPORATED reports $190.8M in lifetime Medicaid revenue and has no Medicare billing on file, making its commercial payer footprint effectively single‑payer Medicaid in the available data. The organization’s NPI was enumerated on 2006-03-20 (~20 years ago), indicating long tenure in the market; analysts should treat this as a Medicaid‑focused entity with a stable enrollment history.

Revenue is highly concentrated among a small set of evaluation-and-management codes: the precomputed top three codes (99284, 99285, 99214) account for 40.9% of total Medicaid revenue. Specifically, 99284 produced $24.1M (15.2%), 99285 produced $21.1M (13.3%), and 99214 produced $19.6M (12.4%), so a large share of Medicaid dollars flows through a few E/M services.

The code mix strongly indicates a major emergency department and high‑acuity ambulatory practice footprint: 99284 (ED moderate MDM) and 99285 (ED high MDM) are the top two revenue drivers and 99283 also appears high on the list, together reflecting very large ED volume and substantial high‑acuity ED encounters. The presence of 99291 (critical care) and high ranked CT/echocardiography codes supports that ED visits frequently escalate to critical care and imaging.

Alongside emergency medicine, the profile shows a substantial outpatient/internal medicine service line. High revenue and volume for 99214, 99215, 99213 and preventive codes 99391/99392, plus frequent diagnostic services such as 93306, 93303, 93010, and 70553, point to broad primary care and cardiology/diagnostic capacity within the practice or its billing group. This mix suggests integrated ambulatory care with on‑site diagnostic capability rather than a narrow specialty clinic.

Inpatient and neonatal services are material components of the billing mix: 99233 and 99232 (subsequent inpatient care) and 99291 (critical care) appear among top revenue codes, and neonatal codes 99472, 99469 and 99480 contribute meaningful Medicaid revenue. The data indicate active inpatient and NICU-level care rather than purely outpatient activity.

Competitive standing in Colorado is dominant for many high‑revenue codes: the provider ranks #1 statewide for 99284 (1 of 267), 99285 (1 of 213), 99214 (1 of 2632), 99215 (1 of 724) and several diagnostic codes, with the dataset labeling these volumes as "extreme outlier" or in the 100th percentile. That statewide leadership suggests this entity is a major Medicaid service provider whose activity is far above typical peers for numerous E/M and diagnostic codes.

There is variability by code in how extreme the provider’s position is: most top codes are labeled "extreme outlier," but some high‑volume imaging codes (e.g., 74177 at the 97th percentile) are described as "notably above typical," while neonatal follow‑up 99469 is described as "typical, unremarkable" (60th percentile). Analysts should therefore expect pockets of extraordinarily high volume alongside some services where the provider’s utilization is closer to peer norms.

From a payer/operational risk perspective, the combination of heavy Medicaid dependence (no Medicare revenue on file) and revenue concentration in a few ED/ E/M codes means policy or reimbursement changes affecting ED payments or Medicaid coverage could materially affect revenue. For contracting, utilization management, and network decisions, focus due diligence on ED throughput, critical care escalation rates (99291), and the high‑volume diagnostic capabilities that support the large E/M volumes.

Medicaid: Complete Services Breakdown

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

421 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	256,420	$90	$24.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	166,500	$130	$21.1M
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…	228,240	$90	$19.6M
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…	150,530	$110	$16.6M
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.	188,160	$50	$9.6M
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…	150,010	$60	$9M
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…	99,030	$70	$6.8M
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…	48,970	$140	$6.7M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	14,560	$390	$5.7M
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…	60,350	$90	$5.6M

Showing 1–10 of 421

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Colorado providers billing the same CPT/HCPCS codes.

Claims Volume vs. Colorado Distribution

University Physicians Incorporated — 24 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Colorado

Full comparison — all codes billed, vs. Colorado median

421 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
G0483	Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…	12	40	900	$170	$1.5M
99469	The provider evaluates and manages the subsequent care of a newborn or infant less than 28 days of age in a neonatal critical care setting, after the first day.	3	10	3,690	$300	$1.3M
99472	The provider performs follow up care of a critically ill infant or young child, 29 days through 24 months of age, in an inpatient setting.	1	10	90	$380	$1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	1	210	730	$120	$966.7K
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.	1	290	1,390	$110	$958.7K
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.	1	270	1,290	$100	$937.1K
99479	The provider directs the care of a recovering low birth weight infant, whose current weight is between 1500 and 2500 grams.	3	10	3,380	$90	$493.7K
95782	A patient under the age of 6 undergoes an attended sleep study with identification of sleep levels and at least four additional sleep parameters.	1	10	90	$710	$384.6K
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	240	$120	$356.5K
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…	4	2,520	330	$100	$352K

Showing 1–10 of 421

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Laboratory Corporation Of America Holdings	NC	Clinical Medical Laboratory	$214.6M	$1.4B
Laboratory Corporation Of America Holdings	NJ	Clinical Medical Laboratory	$143.3M	$717.5M
Natera, Inc.	CA	Clinical Medical Laboratory	$133.1M	$641.5M
Unilab Corporation	CA	Clinical Medical Laboratory	$94M	$668.5M
Bioreference Health, LLC	NJ	Clinical Medical Laboratory	$66.8M	$620.1M
Laboratory Corporation Of America Holdings	OH	Clinical Medical Laboratory	$56.9M	$617M
Millennium Health, LLC	CA	Clinical Medical Laboratory	$20.4M	$579.3M
Exact Sciences Laboratories, LLC	WI	Clinical Medical Laboratory	$299.3M	$276.5M
Aeroflow Inc.	NC	Durable Medical Equipment & Medical Supplies	$0	$571.9M
Zoll Services LLC	PA	Durable Medical Equipment & Medical Supplies	$0	$503.8M

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Children's Hospital Colorado	CO	Children's Hospital	$0	$114.9M
University Of Colorado Hospital Authority	CO	General Acute Care Hospital	$0	$58.1M
Prosthetic & Orthotic Group Pediatric Specialists - Colorado LLC	CO	Prosthetic/Orthotic Supplier	$0	$7.3M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$0	$6.7M
Children's Optical, LLC	CO	Pediatric Optometrist	$0	$6.4M
Rmchs Management	CO	Pediatric Dentistry	$0	$4.4M
University Physicians Incorporated	CO	Clinical Medical Laboratory	$271.4K	$3.4M
Marisa Lau	CO	Ophthalmology Physician	$2M	$0
Jorge Monge Urrea	CO	Hematology & Oncology Physician	$1.9M	$18.9K
University Physicians Incorporated	CO	Clinical Medical Laboratory	$509.9K	$886.9K

University Physicians Incorporated — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References