Active NPI 1982846119 Individual Practitioner Male Practitioner

Dr. Benjamin Clark Jacobs , MD

Radiology - Diagnostic Radiology • Provo, UT

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Benjamin Jacobs, MD is a certified Radiology - Diagnostic Radiology practicing in Provo, UT. With approximately 17 years of clinical experience since graduating from Washington University School Of Medicine in 2009, Dr. Jacobs delivers high-quality medical care to the local community at 1055 N 500 W.

Dr. Jacobs is affiliated with Revere Health Pc and accepts Medicare assignment.

Frequently performed procedures and clinical services include low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml, injection, gadoterate meglumine, 0.1 ml, injection, dexamethasone sodium phosphate, 1 mg. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1055 N 500 W
Ste 112

Provo, UT 846043305

Telephone 8018124624

Fax 8018124699

Associated Practice Facility / Clinic

🏢 No Roll Up Timpanogos Llc Facility NPI 1831153840

Medicare Profile & Education

Medical School

Washington University School Of Medicine

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Radiology - Diagnostic Radiology in Provo, UT

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs -8.8 yrs vs City Avg

City Avg: 25.8 Yrs

State Avg: 23.8 Yrs

Regional Practice Density

49 Specialists

Practicing in Provo, UT (341 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

76.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Jacobs (17 Years) 17 Yrs

Provo Specialty Average (25.8 Years) 25.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	10,501	132	$1.00	$0.13
A9575 Injection, gadoterate meglumine, 0.1 ml	6,921	48	$0.89	$0.12
J1100 Injection, dexamethasone sodium phosphate, 1 mg	120	12	$6.50	$0.10
71046 X-ray of chest, 2 views	99	97	$94.17	$29.73
74177 Ct scan of abdomen and pelvis with contrast	68	65	$911.97	$284.24
71045 X-ray of chest, 1 view	66	58	$26.26	$8.01
72148 MRI scan of lower spinal canal	64	64	$1020.64	$174.75
73721 Mri scan of leg joint without contrast	50	49	$919.00	$190.83
71260 Ct scan of chest with contrast	47	45	$607.00	$118.72
77080 Dxa bone density measurement of hip, pelvis, spine	43	43	$223.00	$35.95
73221 Mri scan of arm joint without contrast	40	39	$897.23	$187.51
76770 Complete ultrasound scan behind abdominal cavity	37	37	$318.00	$98.13
73700 Ct scan of leg without contrast	34	33	$448.71	$117.76
71250 Ct scan of chest without contrast	32	32	$515.00	$113.00
74018 X-ray of abdomen, 1 view	31	31	$86.94	$27.41
77067 Screening mammography	30	30	$374.87	$118.14
74176 Ct scan of abdomen and pelvis without contrast	30	30	$554.03	$173.80
77063 Screening digital tomography of both breasts	30	30	$155.07	$48.62
71275 Ct scan of blood vessels of chest with contrast	28	28	$993.00	$239.25
82565 Blood creatinine level	26	26	$11.00	$5.02
72100 X-ray of lower and sacral spine, 2-3 views	25	23	$117.00	$37.00
70450 Ct scan head or brain without contrast	25	25	$121.00	$37.34
72141 MRI scan of upper spinal canal	23	23	$927.00	$161.81
74177 Ct scan of abdomen and pelvis with contrast	21	21	$258.38	$79.14
73562 X-ray of knee, 3 views	21	18	$111.05	$34.97
73630 X-ray of foot, minimum of 3 views	21	21	$82.76	$25.02
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	20	20	$264.15	$100.79
72110 X-ray of lower and sacral spine, minimum of 4 views	19	19	$151.84	$48.08
73502 X-ray of hip, 2-3 views	19	19	$127.74	$39.90
76536 Ultrasound of head and neck	18	18	$322.00	$102.35
70553 Mri scan of brain before and after contrast	18	18	$1878.00	$298.82
74183 Mri scan of abdomen before and after contrast	18	18	$1865.00	$322.30
73130 X-ray of hand, minimum of 3 views	15	12	$103.47	$32.86
72040 X-ray of upper spine, 2-3 views	15	15	$110.47	$35.03
71275 Ct scan of blood vessels of chest with contrast	15	15	$258.13	$81.83
73030 X-ray of shoulder, minimum of 2 views	12	11	$84.25	$26.35
70450 Ct scan head or brain without contrast	12	12	$377.67	$93.23
72070 X-ray of middle spine, 2 views	11	11	$90.82	$28.61
76705 Limited ultrasound scan of abdomen	11	11	$255.36	$81.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	11,231	153	$1.00	$0.15
A9585 Injection, gadobutrol, 0.1 ml	7,030	91	$1.95	$0.33
77080 Dxa bone density measurement of hip, pelvis, spine	131	131	$221.52	$35.23
71046 X-ray of chest, 2 views	122	121	$93.09	$29.85
74177 Ct scan of abdomen and pelvis with contrast	79	77	$922.30	$292.89
72148 MRI scan of lower spinal canal	73	73	$981.00	$177.57
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	62	12	$3.00	$1.04
71045 X-ray of chest, 1 view	55	48	$27.00	$8.32
71260 Ct scan of chest with contrast	55	52	$607.00	$114.97
73721 Mri scan of leg joint without contrast	53	50	$919.00	$183.38
71250 Ct scan of chest without contrast	45	45	$515.00	$125.46
73221 Mri scan of arm joint without contrast	44	43	$915.00	$185.90
76770 Complete ultrasound scan behind abdominal cavity	42	42	$317.71	$102.30
70553 Mri scan of brain before and after contrast	40	40	$1878.00	$284.11
73562 X-ray of knee, 3 views	39	32	$117.97	$38.03
82565 Blood creatinine level	36	36	$11.00	$5.02
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	34	34	$286.76	$110.96
73700 Ct scan of leg without contrast	33	33	$458.00	$122.48
J1040 Injection, methylprednisolone acetate, 80 mg	32	30	$18.00	$11.88
76536 Ultrasound of head and neck	32	32	$324.00	$105.03
70450 Ct scan head or brain without contrast	30	29	$121.00	$38.53
73030 X-ray of shoulder, minimum of 2 views	29	23	$98.14	$31.12
72100 X-ray of lower and sacral spine, 2-3 views	28	28	$110.93	$35.66
74018 X-ray of abdomen, 1 view	26	26	$87.81	$28.26
72141 MRI scan of upper spinal canal	26	26	$927.00	$165.60
73502 X-ray of hip, 2-3 views	25	25	$128.52	$41.38
72110 X-ray of lower and sacral spine, minimum of 4 views	25	25	$144.48	$46.75
74176 Ct scan of abdomen and pelvis without contrast	25	25	$554.60	$177.45
36415 Insertion of needle into vein for collection of blood sample	21	21	$14.76	$8.40
77063 Screening digital tomography of both breasts	20	20	$155.85	$49.98
J2250 Injection, midazolam hydrochloride, per 1 mg	20	14	$6.00	$0.15
77067 Screening mammography	20	20	$372.80	$120.16
71275 Ct scan of blood vessels of chest with contrast	20	20	$956.30	$236.56
74183 Mri scan of abdomen before and after contrast	18	18	$1865.00	$332.39
64483 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level	18	17	$787.44	$238.46
77002 Fluoroscopic guidance for needle placement	18	18	$337.83	$109.30
73630 X-ray of foot, minimum of 3 views	17	16	$95.47	$30.87
70551 Mri scan of brain without contrast	16	16	$948.00	$184.26
76705 Limited ultrasound scan of abdomen	16	15	$256.75	$83.69
72040 X-ray of upper spine, 2-3 views	15	13	$110.33	$35.53
72158 Mri scan of lower spinal canal before and after contrast	15	15	$1872.00	$282.49
73130 X-ray of hand, minimum of 3 views	15	12	$108.00	$34.53
70450 Ct scan head or brain without contrast	15	15	$382.33	$87.88
72146 Mri scan of middle spinal canal	14	14	$936.93	$156.55
73110 X-ray of wrist, minimum of 3 views	13	13	$111.85	$35.43
J3010 Injection, fentanyl citrate, 0.1 mg	13	13	$2.00	$0.89
Q9966 Low osmolar contrast material, 200-299 mg/ml iodine concentration, per ml	13	13	$2.00	$0.42
64484 Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, each additional level	12	11	$361.00	$105.40
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	12	12	$127.00	$46.85
93880 Ultrasound of both sides of head and neck blood flow	12	12	$428.83	$179.26
73610 X-ray of ankle, minimum of 3 views	12	12	$108.00	$34.35
72070 X-ray of middle spine, 2 views	12	12	$90.50	$29.23
70544 Mri scan of blood vessels of head without contrast	12	12	$1055.00	$196.92
70491 CT scan of neck with contrast	12	11	$558.00	$149.83
62323 Injection of substance into lower spine canal using imaging guidance	12	11	$538.00	$243.09
20610 Aspiration and/or injection of fluid from large joint	12	11	$156.00	$58.75
76700 Ultrasound of abdomen	11	11	$320.45	$103.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	20,186	253	$1.00	$0.12
A9585 Injection, gadobutrol, 0.1 ml	5,203	70	$1.08	$0.33
J1100 Injection, dexamethasone sodium phosphate, 1 mg	130	13	$5.15	$0.12
74177 Ct scan of abdomen and pelvis with contrast	122	118	$927.77	$306.83
77067 Screening mammography	104	104	$368.90	$122.54
77063 Screening digital tomography of both breasts	104	104	$153.00	$50.64
71260 Ct scan of chest with contrast	92	84	$607.00	$125.11
72148 MRI scan of lower spinal canal	72	72	$981.00	$189.85
77080 Dxa bone density measurement of hip, pelvis, spine	59	59	$223.00	$34.94
71045 X-ray of chest, 1 view	59	52	$25.85	$8.65
73700 Ct scan of leg without contrast	49	48	$458.00	$128.81
71046 X-ray of chest, 2 views	48	47	$97.00	$31.31
73721 Mri scan of leg joint without contrast	47	44	$919.00	$193.06
73221 Mri scan of arm joint without contrast	45	43	$901.67	$188.98
71250 Ct scan of chest without contrast	43	43	$515.00	$129.44
71275 Ct scan of blood vessels of chest with contrast	41	40	$993.00	$245.43
74176 Ct scan of abdomen and pelvis without contrast	39	39	$550.92	$181.25
70553 Mri scan of brain before and after contrast	36	36	$1873.67	$314.24
82565 Blood creatinine level	33	33	$11.00	$5.06
36415 Insertion of needle into vein for collection of blood sample	32	32	$10.00	$2.97
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	30	30	$272.80	$110.27
70450 Ct scan head or brain without contrast	29	28	$119.59	$39.26
76770 Complete ultrasound scan behind abdominal cavity	29	29	$316.83	$104.90
72141 MRI scan of upper spinal canal	23	23	$927.00	$169.74
76705 Limited ultrasound scan of abdomen	22	22	$247.59	$82.01
76536 Ultrasound of head and neck	21	20	$324.43	$107.84
J2250 Injection, midazolam hydrochloride, per 1 mg	21	13	$6.00	$0.16
73562 X-ray of knee, 3 views	19	16	$117.00	$38.50
74178 Ct scan of abdomen and pelvis before and after contrast	19	19	$1038.74	$333.13
93880 Ultrasound of both sides of head and neck blood flow	18	18	$441.78	$183.78
70450 Ct scan head or brain without contrast	18	16	$401.00	$105.27
76642 Limited ultrasound scan of 1 breast	18	18	$246.50	$82.22
72110 X-ray of lower and sacral spine, minimum of 4 views	17	17	$147.00	$48.35
72158 Mri scan of lower spinal canal before and after contrast	15	15	$1872.00	$321.71
70486 CT scan of face	15	15	$466.00	$118.35
72100 X-ray of lower and sacral spine, 2-3 views	14	13	$115.00	$37.73
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	14	14	$106.14	$50.84
72131 CT scan of lower spine	13	13	$515.00	$113.26
73200 Ct scan of arm without contrast	13	13	$490.23	$133.55
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	13	13	$127.00	$47.99
J3010 Injection, fentanyl citrate, 0.1 mg	13	13	$2.00	$0.78
70491 CT scan of neck with contrast	13	12	$556.23	$159.93
93970 Ultrasound study of arm or leg veins with compression and maneuvers	12	12	$420.00	$180.26
70496 Ct scan of blood vessels of head with contrast	11	11	$1196.91	$235.46

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	15,343	186	$1.00	$0.12
A9585 Injection, gadobutrol, 0.1 ml	5,611	71	$2.00	$0.35
77063 Screening digital tomography of both breasts	146	146	$152.96	$52.51
77067 Screening mammography	143	143	$368.21	$125.40
71045 X-ray of chest, 1 view	102	89	$25.17	$8.80
74177 Ct scan of abdomen and pelvis with contrast	85	82	$940.71	$312.17
72148 MRI scan of lower spinal canal	59	59	$981.00	$195.56
71260 Ct scan of chest with contrast	57	53	$607.00	$123.01
73221 Mri scan of arm joint without contrast	56	53	$905.07	$201.31
73721 Mri scan of leg joint without contrast	55	54	$919.00	$208.98
71250 Ct scan of chest without contrast	48	46	$515.00	$131.19
76642 Limited ultrasound scan of 1 breast	41	34	$247.90	$84.12
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	39	39	$341.23	$109.47
76536 Ultrasound of head and neck	38	38	$330.63	$108.88
36415 Insertion of needle into vein for collection of blood sample	36	34	$10.00	$3.00
72141 MRI scan of upper spinal canal	34	34	$927.00	$180.58
82565 Blood creatinine level	34	33	$11.00	$5.12
70450 Ct scan head or brain without contrast	33	33	$117.48	$40.17
76770 Complete ultrasound scan behind abdominal cavity	32	32	$321.59	$107.70
73700 Ct scan of leg without contrast	32	32	$438.00	$126.65
71275 Ct scan of blood vessels of chest with contrast	32	32	$993.00	$244.59
72158 Mri scan of lower spinal canal before and after contrast	30	30	$1753.60	$298.43
76705 Limited ultrasound scan of abdomen	27	27	$258.26	$84.88
74176 Ct scan of abdomen and pelvis without contrast	27	27	$546.74	$184.97
70553 Mri scan of brain before and after contrast	27	27	$1800.00	$304.27
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	25	25	$103.00	$52.51
73200 Ct scan of arm without contrast	21	21	$504.05	$147.84
70450 Ct scan head or brain without contrast	18	18	$401.00	$106.97
93880 Ultrasound of both sides of head and neck blood flow	17	17	$552.00	$189.52
J1040 Injection, methylprednisolone acetate, 80 mg	17	15	$17.88	$10.61
74177 Ct scan of abdomen and pelvis with contrast	17	17	$251.47	$87.18
93970 Ultrasound study of arm or leg veins with compression and maneuvers	16	16	$537.00	$185.75
71275 Ct scan of blood vessels of chest with contrast	16	16	$251.50	$86.86
71046 X-ray of chest, 2 views	16	16	$93.88	$31.96
74178 Ct scan of abdomen and pelvis before and after contrast	15	15	$1062.00	$354.75
70491 CT scan of neck with contrast	15	13	$565.33	$178.02
76882 Limited ultrasound scan of joint or other extremity structure except blood vessels	15	13	$160.73	$54.17
76700 Ultrasound of abdomen	14	14	$348.00	$116.56
77066 Diagnostic mammography of both breasts	14	14	$456.57	$155.21
70486 CT scan of face	13	13	$466.00	$127.78
72156 Mri scan of upper spinal canal before and after contrast	12	12	$1814.00	$291.55
77002 Fluoroscopic guidance for needle placement	12	12	$334.00	$110.66
20610 Aspiration and/or injection of fluid from large joint	12	11	$153.00	$56.81
74183 Mri scan of abdomen before and after contrast	12	12	$1787.00	$363.90
77065 Diagnostic mammography of 1 breast	11	11	$361.73	$122.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	11,900	150	$1.00	$0.11
A9585 Injection, gadobutrol, 0.1 ml	7,474	100	$1.91	$0.36
71045 X-ray of chest, 1 view	162	148	$26.00	$9.10
72148 MRI scan of lower spinal canal	87	86	$970.03	$202.95
77063 Screening digital tomography of both breasts	78	78	$152.13	$53.22
77067 Screening mammography	78	78	$373.13	$130.48
73221 Mri scan of arm joint without contrast	62	60	$914.71	$216.07
74177 Ct scan of abdomen and pelvis with contrast	58	56	$885.53	$309.96
73721 Mri scan of leg joint without contrast	52	49	$920.27	$205.04
70450 Ct scan head or brain without contrast	50	48	$121.08	$41.98
72158 Mri scan of lower spinal canal before and after contrast	39	39	$1783.95	$343.66
71260 Ct scan of chest with contrast	39	37	$604.05	$144.41
71046 X-ray of chest, 2 views	39	39	$84.33	$29.45
70553 Mri scan of brain before and after contrast	37	36	$1794.38	$317.38
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	32	32	$355.34	$112.70
71250 Ct scan of chest without contrast	31	30	$510.65	$142.50
76770 Complete ultrasound scan behind abdominal cavity	30	30	$309.23	$108.09
71275 Ct scan of blood vessels of chest with contrast	30	29	$974.33	$257.81
72141 MRI scan of upper spinal canal	30	30	$920.07	$177.01
36415 Insertion of needle into vein for collection of blood sample	30	30	$10.00	$2.99
82565 Blood creatinine level	28	28	$11.00	$5.11
73700 Ct scan of leg without contrast	25	21	$466.16	$143.51
76705 Limited ultrasound scan of abdomen	25	25	$249.04	$87.03
74176 Ct scan of abdomen and pelvis without contrast	23	23	$547.35	$189.38
76536 Ultrasound of head and neck	21	21	$315.19	$110.29
99153 Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes	21	12	$27.90	$9.93
J2250 Injection, midazolam hydrochloride, per 1 mg	21	11	$6.00	$0.12
74178 Ct scan of abdomen and pelvis before and after contrast	20	20	$996.90	$348.67
74177 Ct scan of abdomen and pelvis with contrast	17	17	$259.29	$87.34
93880 Ultrasound of both sides of head and neck blood flow	17	17	$551.94	$187.52
72100 X-ray of lower and sacral spine, 2-3 views	16	16	$103.50	$35.90
73200 Ct scan of arm without contrast	16	15	$486.13	$143.99
72146 Mri scan of middle spinal canal	16	15	$985.44	$150.34
71275 Ct scan of blood vessels of chest with contrast	16	16	$258.00	$90.64
70450 Ct scan head or brain without contrast	16	16	$397.00	$105.61
J3010 Injection, fentanyl citrate, 0.1 mg	14	13	$1.86	$0.90
70551 Mri scan of brain without contrast	14	14	$949.43	$213.14
76642 Limited ultrasound scan of 1 breast	13	11	$240.15	$84.25
72125 Ct scan of upper spine without contrast	13	13	$148.23	$48.79
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	12	12	$56.00	$22.24
J1040 Injection, methylprednisolone acetate, 80 mg	12	12	$16.00	$10.66
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	12	12	$103.00	$53.22
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	12	12	$131.00	$47.92
74018 X-ray of abdomen, 1 view	12	11	$79.83	$27.57
77002 Fluoroscopic guidance for needle placement	11	11	$294.00	$102.73
76700 Ultrasound of abdomen	11	11	$336.00	$114.29
72131 CT scan of lower spine	11	11	$515.00	$138.12

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	15,927	195	$1.00	$0.11
A9585 Injection, gadobutrol, 0.1 ml	7,386	96	$1.00	$0.36
71045 X-ray of chest, 1 view	104	90	$26.00	$9.23
72148 MRI scan of lower spinal canal	97	97	$881.56	$204.51
74177 Ct scan of abdomen and pelvis with contrast	87	86	$873.62	$297.60
71260 Ct scan of chest with contrast	63	58	$585.46	$144.60
70450 Ct scan head or brain without contrast	57	57	$122.82	$41.97
71046 X-ray of chest, 2 views	51	49	$85.31	$29.48
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	50	46	$365.00	$113.78
77063 Screening digital tomography of both breasts	49	49	$153.00	$53.48
77067 Screening mammography	48	48	$374.58	$130.37
73721 Mri scan of leg joint without contrast	47	46	$924.43	$217.19
73700 Ct scan of leg without contrast	44	40	$481.36	$149.90
70553 Mri scan of brain before and after contrast	43	43	$1705.58	$352.79
73221 Mri scan of arm joint without contrast	42	40	$903.62	$215.84
71275 Ct scan of blood vessels of chest with contrast	35	35	$922.14	$271.13
71250 Ct scan of chest without contrast	34	34	$462.44	$146.99
72158 Mri scan of lower spinal canal before and after contrast	33	33	$1630.94	$331.54
76770 Complete ultrasound scan behind abdominal cavity	32	32	$310.50	$106.08
99153 Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes	31	17	$27.00	$10.09
72141 MRI scan of upper spinal canal	30	30	$878.47	$187.02
J2250 Injection, midazolam hydrochloride, per 1 mg	28	16	$6.00	$0.12
74176 Ct scan of abdomen and pelvis without contrast	28	28	$544.18	$183.20
93880 Ultrasound of both sides of head and neck blood flow	27	27	$551.00	$192.94
76705 Limited ultrasound scan of abdomen	25	25	$250.36	$86.04
70450 Ct scan head or brain without contrast	25	25	$368.32	$109.71
74178 Ct scan of abdomen and pelvis before and after contrast	22	22	$985.27	$344.79
36415 Insertion of needle into vein for collection of blood sample	20	20	$10.00	$2.94
71046 X-ray of chest, 2 views	20	20	$31.00	$11.00
93970 Ultrasound study of arm or leg veins with compression and maneuvers	19	18	$488.42	$170.63
76536 Ultrasound of head and neck	19	18	$316.26	$102.21
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	18	17	$131.00	$48.83
J3010 Injection, fentanyl citrate, 0.1 mg	18	17	$1.00	$0.81
72146 Mri scan of middle spinal canal	17	16	$899.24	$199.88
74176 Ct scan of abdomen and pelvis without contrast	17	16	$251.65	$88.11
74177 Ct scan of abdomen and pelvis with contrast	17	17	$263.82	$92.33
72125 Ct scan of upper spine without contrast	17	16	$154.82	$52.74
82565 Blood creatinine level	15	15	$11.00	$5.58
71275 Ct scan of blood vessels of chest with contrast	15	15	$262.80	$87.03
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	14	14	$131.00	$12.50
72100 X-ray of lower and sacral spine, 2-3 views	13	13	$32.00	$10.70
70486 CT scan of face	13	13	$492.00	$133.42
74018 X-ray of abdomen, 1 view	12	12	$77.50	$27.32
73200 Ct scan of arm without contrast	12	12	$491.00	$138.17
70551 Mri scan of brain without contrast	12	12	$917.50	$198.29
70551 Mri scan of brain without contrast	12	12	$360.00	$73.05

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	15,191	180	$1.00	$0.12
A9585 Injection, gadobutrol, 0.1 ml	6,296	83	$1.00	$0.37
71045 X-ray of chest, 1 view	106	90	$26.82	$9.10
72148 MRI scan of lower spinal canal	105	105	$981.00	$204.44
77067 Screening mammography	94	94	$378.00	$129.93
77063 Screening digital tomography of both breasts	94	94	$153.00	$52.81
74177 Ct scan of abdomen and pelvis with contrast	84	80	$855.00	$289.37
71046 X-ray of chest, 2 views	73	73	$84.00	$28.14
71250 Ct scan of chest without contrast	56	50	$514.00	$154.32
73221 Mri scan of arm joint without contrast	51	50	$914.00	$218.28
73721 Mri scan of leg joint without contrast	46	44	$930.00	$223.56
71260 Ct scan of chest with contrast	44	41	$607.00	$143.89
73700 Ct scan of leg without contrast	42	40	$493.00	$149.62
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	42	41	$365.00	$114.59
71275 Ct scan of blood vessels of chest with contrast	40	40	$993.00	$279.83
72141 MRI scan of upper spinal canal	35	35	$927.00	$208.05
36415 Insertion of needle into vein for collection of blood sample	35	35	$10.00	$2.94
70553 Mri scan of brain before and after contrast	34	34	$1799.00	$344.26
72158 Mri scan of lower spinal canal before and after contrast	34	33	$1794.00	$325.49
J2250 Injection, midazolam hydrochloride, per 1 mg	33	14	$6.00	$0.12
76770 Complete ultrasound scan behind abdominal cavity	29	29	$314.00	$108.47
71046 X-ray of chest, 2 views	29	29	$32.83	$10.84
70450 Ct scan head or brain without contrast	27	27	$121.00	$41.54
99153 Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes	26	11	$27.00	$10.26
74176 Ct scan of abdomen and pelvis without contrast	26	26	$555.00	$192.20
76536 Ultrasound of head and neck	25	24	$321.00	$110.92
82565 Blood creatinine level	23	23	$11.00	$6.20
70450 Ct scan head or brain without contrast	21	20	$401.00	$106.94
77063 Screening digital tomography of both breasts	19	19	$85.00	$29.60
J3010 Injection, fentanyl citrate, 0.1 mg	19	15	$1.00	$0.54
77067 Screening mammography	19	19	$108.00	$37.61
76705 Limited ultrasound scan of abdomen	18	18	$253.00	$87.69
93880 Ultrasound of both sides of head and neck blood flow	18	18	$551.00	$193.62
74178 Ct scan of abdomen and pelvis before and after contrast	17	17	$968.00	$330.73
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	16	15	$128.00	$48.85
70486 CT scan of face	16	16	$492.00	$129.25
74177 Ct scan of abdomen and pelvis with contrast	15	15	$261.00	$91.03
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	15	15	$128.00	$12.71
93970 Ultrasound study of arm or leg veins with compression and maneuvers	15	14	$536.00	$186.76
76642 Limited ultrasound scan of 1 breast	14	12	$245.00	$84.72
73562 X-ray of knee, 3 views	13	12	$98.00	$33.62
74018 X-ray of abdomen, 1 view	12	12	$75.00	$25.66
72100 X-ray of lower and sacral spine, 2-3 views	12	12	$32.00	$11.18
72146 Mri scan of middle spinal canal	12	11	$991.00	$208.04
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	12	12	$123.00	$22.57
J1040 Injection, methylprednisolone acetate, 80 mg	12	12	$17.67	$12.03
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	11	11	$103.00	$53.11
74176 Ct scan of abdomen and pelvis without contrast	11	11	$249.00	$86.81

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
Q9967 Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml	19,747	240	$1.00	$0.12
A9579 Injection, gadolinium-based magnetic resonance contrast agent, not otherwise specified (nos), per ml	1,537	91	$11.00	$1.85
71010 X-ray of chest, 1 view, front	128	107	$26.00	$8.97
74177 Ct scan of abdomen and pelvis with contrast	91	86	$854.00	$287.68
72148 MRI scan of lower spinal canal	90	90	$956.67	$200.39
71020 X-ray of chest, 2 views, front and side	72	72	$76.35	$26.44
70450 Ct scan head or brain without contrast	62	61	$153.50	$41.99
73721 Mri scan of leg joint without contrast	54	49	$914.44	$214.24
73221 Mri scan of arm joint without contrast	54	52	$889.65	$214.19
71260 Ct scan of chest with contrast	52	47	$629.00	$174.85
71275 Ct scan of blood vessels of chest with contrast	50	50	$976.20	$275.49
G0202 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed	47	47	$212.00	$36.50
77063 Screening digital tomography of both breasts	46	46	$87.00	$29.82
77063 Screening digital tomography of both breasts	45	45	$155.00	$52.91
36415 Insertion of needle into vein for collection of blood sample	45	45	$10.00	$2.91
G0202 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (cad) when performed	45	45	$344.00	$127.68
71250 Ct scan of chest without contrast	43	41	$479.81	$148.00
70553 Mri scan of brain before and after contrast	41	41	$1900.00	$346.68
71020 X-ray of chest, 2 views, front and side	39	38	$31.00	$10.82
73700 Ct scan of leg without contrast	38	35	$483.84	$145.19
82565 Blood creatinine level	37	37	$12.00	$6.73
72141 MRI scan of upper spinal canal	34	34	$899.74	$199.11
72158 Mri scan of lower spinal canal before and after contrast	33	33	$1896.79	$339.01
74178 Ct scan of abdomen and pelvis before and after contrast	32	32	$970.00	$324.60
74176 Ct scan of abdomen and pelvis without contrast	23	23	$557.00	$189.13
70551 Mri scan of brain without contrast	22	22	$968.00	$213.90
76770 Complete ultrasound scan behind abdominal cavity	22	22	$314.00	$106.01
74177 Ct scan of abdomen and pelvis with contrast	21	21	$264.00	$86.61
72100 X-ray of lower and sacral spine, 2-3 views	20	19	$32.00	$11.16
74000 X-ray of abdomen, single view	19	19	$66.00	$22.57
70486 CT scan of face	18	18	$479.78	$126.06
70450 Ct scan head or brain without contrast	18	17	$396.56	$104.07
73502 X-ray of hip, 2-3 views	16	16	$32.00	$11.13
G0279 Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)	15	15	$107.00	$53.19
71275 Ct scan of blood vessels of chest with contrast	15	15	$303.60	$90.71
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	14	14	$50.00	$22.06
76642 Limited ultrasound scan of 1 breast	13	11	$246.00	$84.57
73200 Ct scan of arm without contrast	13	13	$493.00	$145.90
74176 Ct scan of abdomen and pelvis without contrast	13	12	$253.00	$86.91
93971 Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers	12	12	$255.00	$110.86
J1040 Injection, methylprednisolone acetate, 80 mg	12	12	$13.00	$11.19
73030 X-ray of shoulder, minimum of 2 views	12	12	$27.00	$9.39
77002 Fluoroscopic guidance for needle placement	12	12	$256.00	$87.77
76705 Limited ultrasound scan of abdomen	11	11	$253.00	$87.05
72125 Ct scan of upper spine without contrast	11	11	$156.00	$52.43

Medical Specialties & State Licenses

CMS Verified: 2025-03-25

Radiology - Diagnostic Radiology Primary Specialty

NUCC Taxonomy Code: 2085R0202X

State License UT 9693882-1205

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

Hospital & Practice Group Affiliations

Revere Health Pc

1055 N 500, Provo, UT 846043305

Phone: 8014298000

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

17 Associated Practitioners

Dr. Scott Valadez , MD

Radiology - Diagnostic Radiology

NPI 1114900206

Doctor of Medicine (M.D.)

Dr. Lance Edmonds , MD

Radiology - Diagnostic Radiology

NPI 1124214374

Doctor of Medicine (M.D.)

Dr. Ralph Reed , MD

Radiology - Diagnostic Radiology

NPI 1144428459

Doctor of Medicine (M.D.)

Shyrlan Beck , PA-C

Physician Assistant

NPI 1144622440

Physician Assistant (Certified)

Dr. Dalton Wright , MD

Radiology - Diagnostic Radiology

NPI 1174569131

Doctor of Medicine (M.D.)

Dr. Jason Allen , DO

Radiology - Diagnostic Radiology

NPI 1184845539

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 25, 2025

Radiology (License #9693882-1205 in UT)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) November 27, 2023

Student in an Organized Health Care Education/Training Program

✅

NPI Profile Active June 21, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location June 21, 2016

Registered at 1055 N 500 W, STE 112, PROVO, UT 846043305 (Tel: 8018124624)

📍

Updated Business Mailing Address June 21, 2016

Registered at 1055 N 500 W, ATTN: CREDENTIALING, PROVO, UT 846043305 (Tel: 8013548225)

👤

Provider Name / Credentials Updated June 21, 2016

Recorded as BENJAMIN JACOBS, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 21, 2016

Radiology (License #9693882-1205 in UT)

🟢

Initial NPI Registration & Enumeration April 02, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1982846119

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 02, 2009

Last Update: March 25, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1055 N 500 W, Attn: Credentialing

Provo, UT 846043305

Phone: 8013548225

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.