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.

Smsj Tucson Holdings LLC (NPI 1265818488)

Smsj Tucson Holdings LLC is a general acute care hospital provider located in Tucson, Arizona. This profile covers 0 Medicare and 310 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	Smsj Tucson Holdings LLC
Address	1601 W Saint Marys Rd
City	Tucson
State	AZ
ZIP	85745
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 11, 2015

Payer Source	Total Paid
Medicaid	$29.8M
Medicare	$0

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

310 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The 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.	46,220	$150	$6.9M
99284	The 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.	39,360	$170	$6.6M
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.	5,800	$460	$2.7M
99285	The 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.	12,470	$130	$1.6M
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.	4,350	$370	$1.6M
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.	8,560	$180	$1.5M
72125	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the cervical spine without contrast material.	2,540	$320	$798.8K
11042	The provider uses surgical instruments to remove the dead tissue in skin down to the subcutaneous layer and including the epidermis and dermis, up to the first 20 cm2.	4,950	$140	$693.4K
78452	In this procedure, the provider performs multiple SPECT studies of the heart to determine the areas of deficient blood flow. The goal of the procedure is to determine areas that have deficient blood…	820	$830	$679.7K
G0378	Hospital observation service, per hour	9,800	$60	$627.2K

Showing 1–10 of 310

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

Smsj Tucson Holdings LLC — 1 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

310 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99285	The 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.	75	260	1,330	$240	$3.5M
99284	The 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.	37	260	3,030	$190	$3.4M
99283	The 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.	23	260	2,600	$170	$2.6M
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.	50	180	1,490	$320	$2.2M
U0003	Infectious 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…	61	110	960	$70	$1.7M
G0378	Hospital observation service, per hour	28	80	6,320	$70	$961.9K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	20	20	250	$40	$915.9K
92507	The provider treats a patient with communication and hearing difficulties by directly interacting with the patient. He assesses the patient with impairment in his ability to make sounds, along with…	217	400	2,110	$70	$800.7K
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	36	50	450	$920	$775.4K
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.	28	150	1,040	$240	$764.4K

Showing 1–10 of 310

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
El Rio Santa Cruz Neighborhood Health Center, Inc	AZ	Federally Qualified Health Center (FQHC)	$0	$360M
Founders Healthcare, LLC	AZ	Durable Medical Equipment & Medical Supplies	$0	$20.8M
Tucson Physician Group Holdings, LLC	AZ	Interventional Cardiology Physician	$0	$11.5M
Behavioral Awareness Center, Inc	AZ	Methadone Clinic	$192.7K	$2.1M
Janakkumar Kansagra	AZ	Interventional Cardiology Physician	$798.6K	$0
Afshin Emami	AZ	Otolaryngology Physician	$512.1K	$0
Alexandre Benjo	AZ	Interventional Cardiology Physician	$352.6K	$0
Susannah Cooper	AZ	Hematology & Oncology Physician	$342.4K	$0
John Migliano	AZ	Hematology & Oncology Physician	$300.2K	$0
Troy Virgil Taduran	AZ	Sports Medicine (Neuromusculoskeletal Medicine) Physician	$278.5K	$0

Smsj Tucson Holdings LLC — Billing Profile & Reimbursement Data

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Smsj Tucson Holdings LLC — 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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