Medicare billing address
CMS Medicare provider billing file
1034 N 500 WProvo, UT 84604
CMS public data · NPI 1104868850
CMS public files list billing, prescribing, location, and participation fields for this NPI. Current plan networks, appointment availability, clinical outcomes, and patient-specific medical advice require separate verification.
CMS display name
Samuel L Southam, MD
Specialty
Credential
MD
NPI
1104868850
Primary source state
UT
Data retrieval date
July 28, 2026
Where these numbers come from, and what they cannot tell you
Public CMS records, 2024 reporting year. These are historical Medicare fields, not proof of current coverage, appointment availability, quality, or what someone will pay.
This page shows Medicare billing and Part D prescribing data for Samuel L Southam, MD from CMS public files. It covers 2024 claims data: services billed, the beneficiary panel, and the most-prescribed Part D drugs. It does not show current coverage, appointment availability, or quality ratings.
A licensed agent, not a call center
Peter Abilla, Licensed Medicare Insurance Sales Agent, NPN 22265186. Bring the doctors and prescriptions that matter to you, then check the details before you enroll.
Medicare participating
Yes
Individual assignment
Yes
Group assignment
Yes
CMS opt-out records
0
When CMS files list more than one address for the same NPI, each address stays tied to the CMS file that reported it.
CMS Medicare provider billing file
1034 N 500 WCMS Doctors & Clinicians file
1034 N 500CMS Doctors & Clinicians file
1055 N 300In the 2024 CMS provider billing file, this NPI had 1,915 Medicare beneficiaries and 2,554 total services. The average beneficiary age was 75, and the average HCC risk score was 1.6.
Total Medicare allowed amount
$94,158.88
Total Medicare payment amount
$71,223.54
Medicare beneficiaries
1,915
Total services
2,554
These percentages describe the Medicare beneficiary panel in the CMS utilization file. They are not a diagnosis for any individual patient and are not a quality score.
Hypertension
74%
CMS beneficiary-panel share
Hyperlipidemia
65%
CMS beneficiary-panel share
Mood disorders
35%
CMS beneficiary-panel share
Ischemic heart disease
33%
CMS beneficiary-panel share
Depression
33%
CMS beneficiary-panel share
Chronic kidney disease
32%
CMS beneficiary-panel share
Where these service numbers come from, and what they cannot tell you
Amounts shown are average Medicare-approved amounts per billed unit in CMS records. What a person pays depends on current coverage and cannot be read from this table alone.
| CMS service description | Services | Avg allowed |
|---|---|---|
| X-ray of chest, 1 view | 384 | $7.86 |
| Ct scan of abdomen and pelvis with contrast | 204 | $79.81 |
| Ct scan of blood vessels of chest with contrast | 108 | $79.91 |
| Ct scan head or brain without contrast | 103 | $36.53 |
| X-ray of chest, 2 views | 86 | $9.82 |
| Mri scan of leg joint without contrast | 84 | $59.66 |
| X-ray of abdomen, 1 view | 73 | $8.20 |
| Ct scan of abdomen and pelvis without contrast | 70 | $76.68 |
| Ct scan of chest without contrast | 54 | $47.33 |
| Ct scan of chest with contrast | 54 | $49.98 |
Medical school
University Of Colorado School Of Medicine, Denver
Graduation year
2003
Group/practice field
Ihc Health Services Inc
Telehealth reported
Not reported
Verify plan-directory status, drug formulary rules, pharmacy pricing, appointment availability, and clinical questions against current plan documents and the relevant provider or care team.
The numbers above come from CMS public-use files for this NPI. Each link identifies the CMS release used and the retrieval date.