Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

University of Utah

Clinic/Center, Dental·Salt Lake City, UT·NPI: 1588656870SharePrint Report
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Red Flags Explained

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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:

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Rate Outlier

Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.

These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.

Risk Assessment

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Bills $95.76 per claim for J3490 (Unclassified drugs) — 16.8× the national median of $5.70.

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Bills $71.92 per claim for 36415 (Collection of venous blood by venipuncture) — 45.8× the national median of $1.57.

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Bills $93.06 per claim for C9803 — 7.0× the national median of $13.20.

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Billing in the top 1% nationally for 17 procedure codes: 36415, J1100, J0690.

This is a statistical summary, not an accusation. See our methodology.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$221.1M

$221,143,873

Total Claims

4.8M

Beneficiaries

3.8M

1.3 claims/patient

Avg Cost/Claim

$46

#385 of 618K providers by total spending(top <0.1%)

🔍 Analysis

Provider Overview

University of Utah is a Clinic/Center, Dental provider based in Salt Lake City, UT. From the 2018–2024 period, this provider received $221.1M in Medicaid payments across 4.8M claims.

Why This Matters

This provider received $221.1M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 27,642 Medicaid beneficiaries for a full year at average per-enrollee costs.

↓ 74% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$26.8M
+14%
2019
$30.5M
+24%
2020
$37.8M
+44%
2021
$54.3M
+1%
2022
$54.9M
-82%
2023
$10.0M
-31%
2024
$6.9M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (G0463 (Hospital outpatient clinic visit)) accounts for 20% of total spending.

G0463Normal range

Hospital outpatient clinic visit

$43.6M

894K claims · 19.7%

Your Cost: $48.76/claim|Median: $26.41
1.9× median
8888888Normal range

Not classified

$42.8M

175K claims · 19.3%

Your Cost: $244.01/claim|Median: $365.77
0.7× median
J3490Top 10%

Unclassified drugs

$15.8M

165K claims · 7.2%

Your Cost: $95.76/claim|Median: $5.70
16.8× median
36415Top 1%

Collection of venous blood by venipuncture

$13.7M

191K claims · 6.2%

Your Cost: $71.92/claim|Median: $1.57
45.8× median
C9803Top 5%

$6.6M

71K claims · 3.0%

Your Cost: $93.06/claim|Median: $13.20
7.0× median
J8499Top 5%

$6.2M

102K claims · 2.8%

Your Cost: $60.81/claim|Median: $1.99
30.6× median
J1100Top 1%

$4.9M

19K claims · 2.2%

Your Cost: $253.00/claim|Median: $0.52
486.5× median
J0690Top 1%

$4.7M

10K claims · 2.1%

Your Cost: $464.96/claim|Median: $0.94
494.6× median
J2704Top 1%

$3.4M

16K claims · 1.5%

Your Cost: $207.61/claim|Median: $0.76
273.2× median
J1885Top 1%

Injection, ketorolac tromethamine, fifteen milligrams

$3.2M

22K claims · 1.5%

Your Cost: $144.28/claim|Median: $0.91
158.6× median
Q9967Top 5%

Low osmolar contrast material, 300-399 mg iodine/ml, per ml

$2.9M

22K claims · 1.3%

Your Cost: $129.81/claim|Median: $3.42
38.0× median
J2250Top 1%

Injection, midazolam HCl, per one milligram

$2.8M

15K claims · 1.3%

Your Cost: $183.77/claim|Median: $0.32
574.3× median
A9576Top 5%

$2.8M

7K claims · 1.2%

Your Cost: $384.98/claim|Median: $8.63
44.6× median
A9270Top 1%

$2.6M

19K claims · 1.2%

Your Cost: $137.77/claim|Median: $0.20
688.8× median
J2930Top 1%

$2.4M

3K claims · 1.1%

Your Cost: $858.06/claim|Median: $3.03
283.2× median
J2405Top 1%

Injection, ondansetron HCl, per one milligram

$1.7M

32K claims · 0.8%

Your Cost: $55.20/claim|Median: $0.58
95.2× median
36416Top 1%

$1.7M

32K claims · 0.8%

Your Cost: $51.82/claim|Median: $1.31
39.5× median
J0330Top 1%

$1.6M

4K claims · 0.7%

Your Cost: $434.93/claim|Median: $1.12
388.3× median
J1200Top 1%

$1.6M

6K claims · 0.7%

Your Cost: $286.57/claim|Median: $0.60
477.6× median
99283Normal range

Emergency dept visit, moderate complexity

$1.4M

30K claims · 0.6%

Your Cost: $45.35/claim|Median: $42.48
1.1× median
J1170Top 1%

Injection, hydromorphone, up to four milligrams

$1.3M

9K claims · 0.6%

Your Cost: $135.58/claim|Median: $1.03
131.6× median
A0431Top 25%

Ambulance service, conventional air, transport, one way

$1.1M

493 claims · 0.5%

Your Cost: $2,302.96/claim|Median: $1,650.68
1.4× median
J0696Top 1%

$1.1M

5K claims · 0.5%

Your Cost: $229.09/claim|Median: $1.34
171.0× median
V2020Top 1%

Frames, purchases

$1.0M

11K claims · 0.5%

Your Cost: $95.67/claim|Median: $19.33
5.0× median
J2270Top 1%

Injection, morphine sulfate, up to ten milligrams

$1.0M

7K claims · 0.5%

Your Cost: $157.58/claim|Median: $1.00
157.6× median
80053Normal range

Comprehensive metabolic panel

$989K

135K claims · 0.4%

Your Cost: $7.31/claim|Median: $7.24
1.0× median
A9552Top 5%

$988K

1K claims · 0.4%

Your Cost: $943.12/claim|Median: $89.01
10.6× median
C1751Top 25%

$985K

29K claims · 0.4%

Your Cost: $34.31/claim|Median: $7.06
4.9× median
J0131Top 1%

$982K

2K claims · 0.4%

Your Cost: $469.17/claim|Median: $5.78
81.2× median
99284Normal range

Emergency dept visit, high complexity

$871K

39K claims · 0.4%

Your Cost: $22.31/claim|Median: $69.51
0.3× median

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