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.

Arizona Pulmonary Specialists Ltd (NPI 1215986468)

Arizona Pulmonary Specialists Ltd is a pulmonary disease physician provider located in Scottsdale, Arizona. This profile covers 0 Medicare and 30 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	Arizona Pulmonary Specialists Ltd
Address	9060 E Via Linda Ste 250
City	Scottsdale
State	AZ
ZIP	85258
Taxonomy	Pulmonary Disease Physician
NPI Enumerated	May 7, 2006

Payer Source	Total Paid
Medicaid	$15.1M
Medicare	$0

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

30 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	33,060	$140	$4.7M
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…	64,280	$70	$4.2M
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…	48,590	$40	$2M
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…	21,840	$50	$1.1M
99308	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a low level of medical decision making and/or the provider…	27,590	$40	$965.8K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	14,650	$50	$717.7K
99255	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a high level of medical decision making or the provider spends at…	3,670	$170	$620.9K
99204	The provider sees a new 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 provider…	2,150	$90	$187.4K
99306	The provider sees a patient for an initial nursing facility care visit involving evaluation and management (E/M). The visit involves high medical decision making, and/or the provider spends at least…	1,160	$100	$114.9K
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…	1,320	$80	$109.8K

Showing 1–10 of 30

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

Arizona Pulmonary Specialists Ltd — 5 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

30 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average 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…	15	540	900	$60	$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…	4	200	410	$170	$442.7K
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…	184	3,040	750	$50	$343.9K
99309	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making or the provider…	21	170	960	$40	$295.2K
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…	2,594	2,780	600	$50	$267K
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…	19	610	610	$50	$258.3K
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…	110	500	250	$110	$164.5K
99254	The provider sees a patient for an inpatient or observation consultation involving evaluation and management (E/M). The E/M involves a moderate level of medical decision making or the provider spends…	47	120	120	$130	$163.6K
99310	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a high level of medical decision making or the provider spends…	53	110	330	$60	$157.2K
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…	574	1,030	130	$70	$134.1K

Showing 1–10 of 30

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Muhammad Raza	AZ	Critical Care Medicine (Internal Medicine) Physician	$628.6K	$0
Aditya Gupta	AZ	Critical Care Medicine (Internal Medicine) Physician	$334.2K	$0
Jonathan Ruzi	AZ	Pulmonary Disease Physician	$329.9K	$0
Heemesh Seth	AZ	Critical Care Medicine (Internal Medicine) Physician	$320.3K	$0
Lorie Loreman	SC	Pulmonary Disease Physician	$279.8K	$0
Bridgett Ronan	AZ	Pulmonary Disease Physician	$255.9K	$0
Louis D'avignon	OR	Pulmonary Disease Physician	$182.2K	$0
Ewa Lupa-laskus	AZ	Pulmonary Disease Physician	$176.4K	$0
Jeremy Feldman	OR	Pulmonary Disease Physician	$157.7K	$0
Reena Bansal	AZ	Critical Care Medicine (Internal Medicine) Physician	$157.4K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dependable Nurses Of Phoenix, LLC	AZ	Home Health Agency	$0	$49.4M
Community Medical Services Montana-private, LLC	AZ	Addiction (Substance Use Disorder) Counselor	$0	$43.2M
Scottsdale Physicians Group Plc	AZ	Internal Medicine Physician	$0	$17.7M
Desert Tranquility Integrated Wellness Services LLC	AZ	Mental Health Clinic/Center (Including Community Mental Health Center)	$0	$16.8M
Scottsdale Recovery Ii, LLC	AZ	Substance Abuse Rehabilitation Facility	$0	$13.7M
Arbor Medical Partners, LLC	AZ	Pediatrics Physician	$0	$12.7M
Purpose Healing Center, LLC	AZ	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.5M
Purpose Healing Center, LLC	AZ	Substance Use Disorder Rehabilitation Clinic/Center	$0	$11.1M
Texan Urgent Care PLLC	AZ	Emergency Medicine Physician	$0	$8.5M
Scottsdale Eye Surgery Center, P.C	AZ	Ambulatory Surgical Clinic/Center	$5.7M	$1.9M

Arizona Pulmonary Specialists Ltd — Billing Profile & Reimbursement Data

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Arizona Pulmonary Specialists Ltd — 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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