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

Why is the Medicaid comparison limited to Arizona 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. Arizona (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.

Banner Hospital Based Physicians Arizona LLC (NPI 1124374822)

Key Findings

Field	Value
Entity Type	Organization
Organization	Banner Hospital Based Physicians Arizona LLC
Address	1900 N Higley Rd
City	Gilbert
State	AZ
ZIP	85234
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	July 31, 2012

Payer Source	Total Paid
Medicaid	$77.8M
Medicare	$0

This provider is effectively a single‑payer Medicaid operation: there is no Medicare billing on file and total Medicaid revenue is $77.8M, indicating the organization’s billed activity and revenue base are concentrated in Medicaid rather than a split Medicare/Medicaid mix. The NPI was enumerated 2012-07-31 (~14 years ago), so the entity has more than a decade of active enrollment supporting that Medicaid-focused footprint.

Revenue is highly concentrated in a small set of inpatient E/M codes: the top 3 Medicaid codes by revenue (99233, 99232, 99223) account for 64.8% of total Medicaid revenue. Specifically, 99233 generated $28.1M (36.2% of Medicaid revenue) on 439.3K claims, 99232 generated $11.6M (14.9%) on 263.3K claims, and 99223 generated $10.7M (13.7%) on 91.2K claims, which together drive the majority of billed dollars.

The code mix and descriptions indicate a hospital‑based, inpatient‑focused clinical operation with large volumes of subsequent and initial inpatient E/M services and discharge/critical care management. High‑revenue codes include inpatient subsequent visits (99233, 99232), initial inpatient high‑complexity visits (99223), discharge day management (99239, $7.2M), and critical care (99291, $8.7M), signaling routine management of high‑acuity hospitalized patients and substantial throughput of inpatient encounters.

Competitive standing in Arizona is dominant for core inpatient E/M and critical care codes: 99233, 99232, 99223, 99291 and 99239 all rank #1 in‑state and are labeled “extreme outlier” (100th percentile) versus peers, which indicates this provider operates at volumes far above typical state activity for those services and is a leading statewide provider for hospital inpatient E/M and critical care billing. Examples include 99233 (ranks #1 of 537 providers, extreme outlier) and 99291 (ranks #1 of 200 providers, extreme outlier).

The provider reports a sizeable critical care footprint separate from routine inpatient E/M: 99291 appears in the top codes with $8.7M revenue (11.1% of Medicaid revenue) on 63.1K claims at $137 avg paid/claim and is an extreme outlier in the state (ranks #1 of 200 providers). This pattern suggests substantial ICU/critical care service delivery in addition to high‑volume inpatient follow‑ups and initial admissions.

Behavioral health services are present but secondary to inpatient E/M: psychotherapy add‑on 90833 yielded $2M (2.6% of Medicaid revenue) on 38.5K claims and ranks #3 of 223 providers (99th percentile, extreme outlier), while psychiatric evaluation 90792 produced $1.3M (1.7%) and ranks #12 of 484 providers (98th percentile, notably above typical). These volumes indicate a notable psychiatry/behavioral health component embedded within the broader hospital‑based practice.

Imaging and ancillary procedural revenue is present but limited relative to inpatient E/M: higher‑volume imaging codes such as 74177 ($139.7K, 1.9K claims, 53rd percentile) and 70450 ($96.6K, 2.9K claims, 59th percentile) are small shares of total Medicaid revenue and are recorded at typical or unremarkable state volumes. This suggests imaging and procedural services support inpatient care but are not major standalone revenue drivers.

Operational scale is evidenced by very large claim counts on core E/M lines that support a high-throughput inpatient platform: examples include 439.3K claims for 99233 and 263.3K claims for 99232, which together reflect sustained, high‑volume inpatient encounter activity over time. Combined with the 2012 NPI enumeration date, the data point to an established, large hospital‑based physician group focused on Medicaid inpatient services.

Medicaid: Complete Services Breakdown

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

55 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	439,320	$60	$28.1M
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	263,340	$40	$11.6M
99223	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the…	91,180	$120	$10.7M
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	63,150	$140	$8.7M
99239	The provider sees a patient for hospital inpatient or observation discharge day management, involving evaluation and management (E/M). The provider spends more than 30 minutes on the service on the…	105,790	$70	$7.2M
99220	N/A	28,340	$90	$2.6M
90833	In this add–on service, the provider performs psychotherapy, a series of techniques for treating the psychiatric disorders of the patient, in addition to an evaluation and management service in the…	38,500	$50	$2M
99222	The provider sees a patient for an initial hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	20,660	$90	$1.8M
99217	N/A	39,270	$40	$1.6M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	12,870	$100	$1.3M

Showing 1–10 of 55

Medicaid: Competitive Analysis & Benchmarks

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

Claims Volume vs. Arizona Distribution

Banner Hospital Based Physicians Arizona LLC — 14 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arizona

Full comparison — all codes billed, vs. Arizona median

55 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
74177	The 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.	83	180	1,490	$320	$2.2M
74176	The provider performs computed tomography of the abdomen and pelvis without contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	97	150	1,040	$240	$764.4K
70450	The 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.	74	180	1,770	$80	$635.2K
72125	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the cervical spine without contrast material.	72	110	1,070	$170	$482K
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…	1	540	900	$60	$475.8K
71275	In this procedure, the provider performs a computed tomographic angiography, or CTA imaging of the chest to get detailed images of the blood vessels but not the heart. He performs this study using a…	69	100	1,350	$170	$475.8K
99291	Critical care services include the treatment of vital organ failure or prevention of further life–threatening conditions. Delivering medical care in a moment of crisis and in time of emergency is…	1	200	410	$170	$442.7K
90870	The provider applies an electric current to the patient's brain for the purpose of producing a seizure or series of seizures to alleviate symptoms of various mental disorders.	10	10	1,560	$190	$407K
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…	2,323	3,040	750	$50	$343.9K
99232	The provider sees a patient for a subsequent hospital inpatient or observation care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or…	1	610	610	$50	$258.3K

Showing 1–10 of 55

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Joshua Carlson	UT	Retina Specialist (Ophthalmology) Physician	$2.6M	$0
Migaela Reedy	AZ	Acute Care Nurse Practitioner	$2M	$0
Hani Rashid	AZ	Rheumatology Physician	$1.9M	$0
Benjamin Benson	AZ	Diagnostic Radiology Physician	$1.3M	$0
Amer Al-khoudari	AZ	Rheumatology Physician	$1.2M	$0
Andrew Kwak	NJ	Diagnostic Radiology Physician	$808.5K	$0
Tamara Lundeen	AZ	Diagnostic Radiology Physician	$802.6K	$0
Caroline Cranford	AZ	Diagnostic Radiology Physician	$724.7K	$0
Ashish Sadhu	AZ	Clinical Cardiac Electrophysiology Physician	$667.6K	$0
Craig Robison	AZ	Interventional Cardiology Physician	$598.1K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Banner Gateway Medical Center	AZ	General Acute Care Hospital	$0	$55.8M
Elite Community Services, LLC	AZ	In Home Supportive Care Agency	$0	$48.2M
Not Only Words Therapy, LLC	AZ	Home Health Agency	$0	$13.1M
Elhadi Osman	AZ	Non-emergency Medical Transport (VAN)	$0	$8.6M
Canyon Pediatrics, Inc	AZ	Primary Care Clinic/Center	$0	$7.9M
David Goldenberg	AZ	Retina Specialist (Ophthalmology) Physician	$4.7M	$15.8K
Sachin Mehta	AZ	Retina Specialist (Ophthalmology) Physician	$4.4M	$11.8K
Surgery Center Of Scottsdale, LLC	AZ	Ambulatory Surgical Clinic/Center	$1.1M	$1.9M
Southwest Endoscopy LLC	AZ	Ambulatory Surgical Clinic/Center	$1.8M	$1M
Kelsey Resler	AZ	Adult Health Nurse Practitioner	$1.4M	$0

Banner Hospital Based Physicians Arizona LLC — Billing Profile & Reimbursement Data

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Banner Hospital Based Physicians Arizona LLC — 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