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    OpenPayerNPI Medicare & MedicaidMaricopa County Special Health Care District
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    Maricopa County Special Health Care District — Billing Profile & Reimbursement Data

    NPI 1073576740 · Phoenix, AZ · General Acute Care Hospital

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    Maricopa County Special Health Care District is a general acute care hospital provider located in Phoenix, Arizona. This profile covers 0 Medicare and 723 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

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    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationMaricopa County Special Health Care District
    Address2601 E Roosevelt St
    CityPhoenix
    StateAZ
    ZIP85008
    TaxonomyGeneral Acute Care Hospital
    NPI EnumeratedApril 11, 2006

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$251.6M
    Medicare$0

    Key Findings

    This provider is effectively single‑payer in the available data: there is no Medicare billing on file while Medicaid revenue totals $251.6M, so Medicaid dominates reported reimbursement and should be treated as the primary payer for operational and contracting analysis. The absence of Medicare claims makes comparisons to national Medicare patterns impossible and underscores reliance on state Medicaid flows.

    Revenue is highly concentrated in a few service lines: the precomputed top 3 Medicaid codes (99283, 99285, 74177) account for 50.9% of the provider's total Medicaid revenue. Those three codes combine emergency department E/M (99283 and 99285) and CT abdomen/pelvis with contrast (74177), signaling that ED encounters and acute imaging are the primary revenue drivers.

    The code mix points to an ED‑centric operation with high acute throughput. 99283 has 131.7K claims and $45.6M revenue and is listed as an extreme outlier (ranks #4 of 258 in-state, 99th percentile), while 99282 has 89.8K claims and $18.6M revenue and is also an extreme outlier (ranks #1 of 159, 100th percentile); 99285 and 99284 also appear among top revenue codes. Together these data indicate heavy volume of both low‑ and high‑acuity ED visits and suggest the hospital’s capacity and billing activity are concentrated on emergency care.

    Imaging and diagnostic services are a major operational backbone tied to the ED pattern: 74177 (29.5K claims, $29.4M revenue, 96th percentile) and CT head 70450 (26.7K claims, $10.7M revenue, 94th percentile) sit among top revenue producers. High volumes of advanced imaging (also including 71275 and 70553) imply significant radiology/CT capacity supporting acute presentations, particularly abdominal/pelvic and neuroimaging workups.

    The provider holds a dominant statewide position for several specific procedures and studies. Multiple codes are flagged as extreme outliers or at the top of state rankings — 99282 (rank #1 of 159, 100th percentile), 99283 (rank #4 of 258, 99th percentile), 99281 (rank #2 of 84, 99th percentile) and 93975 (rank #1 of 50, 100th percentile) — indicating this facility is a major outlier within Arizona for ED visits and certain duplex ultrasound studies, rather than a modest participant.

    Beyond ED and imaging, the dataset shows a sizeable outpatient and ancillary footprint: high counts for office/outpatient visit codes 99213 (126.2K claims, 99th percentile) and 99214 (114.3K claims, 99th percentile), plus T1015 clinic visits and T1016 case management, and therapy code 97110. These items together suggest a broad ambulatory and care‑coordination operation that complements the hospital’s ED and inpatient activity.

    Observation unit and laboratory throughput are nontrivial operational features: G0378 (hospital observation service, 37.1K claims, $3.5M revenue, 85th percentile) and a very large number of CMP claims 80053 (192K claims, $2.1M revenue, 98th percentile) point to heavy observation‑level stays and high‑volume lab processing with low per‑claim reimbursement. This combination is consistent with an ED that funnels many patients into observation and relies on high‑volume lab work for decision support.

    The provider has long tenure in national enrollment, with NPI enumeration on 2006-04-11 (~20 years ago), which, together with the volume and state rankings, indicates an established institution that plays a central role in Arizona’s Medicaid acute care and diagnostic ecosystem. That longevity plus concentration in ED and imaging should inform network capacity planning and competitive assessments.

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    723 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    99283The 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.131,740$350$45.6M
    99285The 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.49,120$610$29.9M
    74177The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.29,530$1,000$29.4M
    99284The 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.48,940$470$23M
    99282The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.89,820$210$18.6M
    70450The provider performed computed tomography, or CT scanning, of the head or brain, without contrast. He performs the procedure to diagnose any brain or intracranial abnormalities.26,650$400$10.7M
    43239The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.3,280$1,210$4M
    72125In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the cervical spine without contrast material.8,760$450$3.9M
    93975The provider performs a complete study of the abdominal, pelvic, scrotal, and or retroperitoneal organs using duplex ultrasound. He performs the procedure to examine the vascular supply to the organs…12,510$300$3.7M
    T1015Clinic visit/encounter, all-inclusive14,300$250$3.6M

    Showing 1–10 of 723

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Arizona median

    723 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    T1015Clinic visit/encounter, all-inclusive1083603,640$230$7.7M
    99285The 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.222601,330$240$3.5M
    99284The 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.302603,030$190$3.4M
    99283The 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.42602,600$170$2.6M
    74177The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.81801,490$320$2.2M
    44970Laparoscopy, surgical, appendectomy510110$4,670$2.1M
    U0003Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…6110960$70$1.7M
    86003The lab analyst performs the technical lab test to analyze a specimen such as serum for allergen–specific immunoglobulin E (IgE), using a crude allergen extract. The test result is quantitative or…4101,620$40$1.3M
    T1016Case management, each 15 minutes2181,1602,110$30$1.2M
    93303The 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…1420160$270$1.1M

    Showing 1–10 of 723

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Maricopa County Special Health Care District, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$56.5M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$24.9M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$19.8M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$19.6M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$18.9M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$17.7M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$17.1M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$15.8M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$15.4M
    Maricopa County Special Health Care DistrictAZFederally Qualified Health Center (FQHC)$0$14.5M

    Nearby Providers

    Other providers in the same ZIP code as Maricopa County Special Health Care District, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    District Medical Group, IncAZInternal Medicine Physician$0$130.6M
    St. Luke's PediatricsAZPrimary Care Clinic/Center$0$31.6M
    Alliance Ambulance Of Arizona LLCAZAmbulance$444.7K$31.1M
    Elevate Youth And Family ServicesAZMental Health Counselor$0$24.6M
    Maricopa County Special Health Care DistrictAZEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center$0$12.5M
    Terros IncAZFederally Qualified Health Center (FQHC)$0$11.9M
    Safe Wing LLCAZNon-emergency Medical Transport (VAN)$0$11.7M
    Mind 247 Practice LLCAZMental Health Clinic/Center (Including Community Mental Health Center)$0$11.5M
    Abc Ambulance LLCAZAmbulance$0$11.4M
    Building Blocks Counseling LLCAZCommunity/Behavioral Health Agency$0$9.7M

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Arizona Providers
    7 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Arizona Distribution
    Maricopa County Special Health Care District — 10 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Arizona