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.

Providence General Medicine, PC (NPI 1164693974)

Providence General Medicine, PC is a internal medicine physician provider located in Phoenix, Arizona. This profile covers 0 Medicare and 74 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

Medicaid: Complete Services Breakdown

Field	Value
Entity Type	Organization
Organization	Providence General Medicine, PC
Address	9220 N. Central Avenue
City	Phoenix
State	AZ
ZIP	85020
Taxonomy	Internal Medicine Physician
NPI Enumerated	March 19, 2008

Payer Source	Total Paid
Medicaid	$8.9M
Medicare	$0

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

74 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	69,140	$50	$3.5M
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…	28,780	$70	$1.9M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	6,010	$90	$516.5K
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	5,740	$90	$493.4K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	6,140	$80	$472.4K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	13,460	$30	$430.8K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	4,010	$80	$304.8K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	2,700	$70	$188.8K
99395	The provider performs an established well–patient visit for a patient who is between the ages of 18 and 39.	1,290	$90	$111.2K
99396	The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.	1,160	$90	$108.1K

Showing 1–10 of 74

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

Providence General Medicine, PC — 4 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

74 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
95165	In this procedure, the provider mixes and prepares the antigens for allergen immunotherapy. Use this code when the provider prepares one or more antigens.	10	80	510	$280	$643.5K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	22	400	200	$120	$403K
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…	141	3,040	750	$50	$343.9K
95004	The provider performs a percutaneous test with allergenic extracts to determine which substances (allergens) trigger an allergic reaction in the patient.	25	80	150	$360	$320.3K
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	37	2,780	600	$50	$267K
90460	In this procedure, the provider administers a single live attenuated vaccine through a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age.	35	420	600	$30	$177K
99391	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	74	300	860	$50	$165.9K
99392	Preventive medicine services are provided to individuals who are not in need of any immediate medical attention, but need to undergo a periodic health checkup as a preventive measure. Well–baby…	47	300	690	$60	$155.9K
99203	The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the provider…	332	1,030	130	$70	$134.1K
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	30	310	470	$60	$131.9K

Showing 1–10 of 74

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Honorhealth	AZ	General Acute Care Hospital	$0	$107.2M
All Valley Home Health Care & Nursing Inc	AZ	Home Health Agency	$0	$55.7M
Bowie Investment Group Inc	AZ	Home Health Agency	$0	$31.9M
Gina Palacios	AZ	Nurse Practitioner	$27M	$0
Affiliated Hospitalists, Plc	AZ	Hospitalist Physician	$0	$21M
Neighborhood Outreach Access To Health	AZ	Federally Qualified Health Center (FQHC)	$0	$19.6M
Avista Senior Living Desert Springs, LLC	AZ	Assisted Living Facility	$0	$17.6M
Unomed LLC	AZ	Critical Care Medicine (Internal Medicine) Physician	$0	$15.4M
Bayada Home Health Care, Inc.	AZ	Home Health Agency	$0	$10.7M
Emcare - Pnx Emergency Physicians LLC	AZ	Emergency Medicine Physician	$0	$9.6M

Providence General Medicine, PC — Billing Profile & Reimbursement Data

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Providence General Medicine, PC — Billing Profile & Reimbursement Data

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Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

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