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.

Sjhmc Physician Services (NPI 1326098005)

Sjhmc Physician Services is a multi-specialty clinic/center provider located in Phoenix, Arizona. This profile covers 0 Medicare and 257 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	Sjhmc Physician Services
Address	350 W Thomas Rd
City	Phoenix
State	AZ
ZIP	85013
Taxonomy	Multi-Specialty Clinic/Center
NPI Enumerated	May 11, 2006

Payer Source	Total Paid
Medicaid	$46.6M
Medicare	$0

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

257 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…	89,770	$70	$6.3M
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…	93,710	$60	$6M
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…	74,580	$50	$3.4M
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.	40,450	$70	$3M
J0585	Injection, onabotulinumtoxina, 1 unit	5,240	$480	$2.5M
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…	17,840	$130	$2.3M
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…	33,380	$50	$1.6M
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…	10,980	$140	$1.6M
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…	16,860	$90	$1.6M
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…	16,310	$70	$1.2M

Showing 1–10 of 257

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

Sjhmc Physician Services — 13 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

257 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.	5	180	1,490	$320	$2.2M
95941	A provider other than the surgeon or anesthesia staff conducts neurophysiology tests, such as electroncephalography or EEG, electromyography or EMG, evoked potentials or nerve conduction study, to…	2	10	570	$3,720	$2.1M
J2350	Injection, ocrelizumab, 1 mg	2	10	140	$12,610	$1.8M
01967	The provider performs neuraxial anesthesia services for a patient undergoing a planned vaginal delivery.	14	30	230	$430	$962.5K
J0585	Injection, onabotulinumtoxina, 1 unit	2	20	260	$670	$920K
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…	173	400	2,110	$70	$800.7K
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.	10	150	1,040	$240	$764.4K
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…	9	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…	6	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…	13	200	410	$170	$442.7K

Showing 1–10 of 257

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Dignity Health	AZ	General Acute Care Hospital	$0	$126.1M
Joseph Bryan	AZ	Retina Specialist (Ophthalmology) Physician	$1.9M	$0
Douglas Debenham	IN	Radiation Oncology Physician	$1.8M	$0
Jason Klein	AZ	Interventional Cardiology Physician	$895.7K	$0
Ana Grace	AZ	Radiation Oncology Physician	$842.8K	$0
Erik Ortega	AZ	Neurology Physician	$776K	$0
Akash Makkar	AZ	Clinical Cardiac Electrophysiology Physician	$753.4K	$0
Muhammad Raza	AZ	Critical Care Medicine (Internal Medicine) Physician	$628.6K	$0
Riyaz Sumar	AZ	Cardiovascular Disease Physician	$538.4K	$0
Guillermo Moguel-cobos	AZ	Neurology Physician	$514.7K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Circle The City	AZ	Federally Qualified Health Center (FQHC)	$0	$30.7M
Empower Emergency Physicians, PC	AZ	Emergency Medicine Physician	$0	$25M
Circle The City	AZ	Federally Qualified Health Center (FQHC)	$0	$20M
St. Joseph's Outpatient Surgery Center, LLC	AZ	Ambulatory Surgical Clinic/Center	$2.9M	$14.5M
Windsor Maryland Gardens, LLC	AZ	Alzheimer Center (Dementia Center)	$0	$9.5M
Solterra 3rd Indian School Operations, LLC	AZ	Assisted Living Facility	$0	$8.2M
Az Center For Change	AZ	Community/Behavioral Health Agency	$0	$7.2M
Crossroads Midtown	AZ	Substance Abuse Rehabilitation Facility	$0	$7M
Atlas Medical Systems, PLLC	AZ	Family Medicine Physician	$0	$6.5M
Bio-medical Applications Of Arizona, LLC	AZ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$6.2M

Sjhmc Physician Services — Billing Profile & Reimbursement Data

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Sjhmc Physician Services — 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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