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.

Leading Healthcare, LLC (NPI 1356853691)

Leading Healthcare, LLC is a hospitalist physician provider located in Sun City, Arizona. This profile covers 0 Medicare and 16 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	Leading Healthcare, LLC
Address	13203 N 103rd Ave Ste I-5
City	Sun City
State	AZ
ZIP	85351
Taxonomy	Hospitalist Physician
NPI Enumerated	October 26, 2017

Payer Source	Total Paid
Medicaid	$7M
Medicare	$0

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

16 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	103,420	$50	$4.8M
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…	40,930	$30	$1.2M
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…	8,170	$70	$531.1K
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…	4,280	$70	$316.6K
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…	1,690	$60	$93K
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…	530	$50	$23.9K
99307	The provider sees a patient for a subsequent nursing facility care visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making or the…	1,000	$20	$17K
99316	The provider sees a patient for nursing facility discharge management requiring more than 30 minutes.	300	$60	$16.5K
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…	140	$70	$9.6K
99336	N/A	140	$40	$5K

Showing 1–10 of 16

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

Leading Healthcare, LLC — 2 of 14 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

16 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…	204	540	900	$60	$475.8K
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…	4	170	960	$40	$295.2K
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…	322	610	610	$50	$258.3K
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…	131	210	320	$70	$177.6K
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…	365	500	250	$110	$164.5K
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…	10	110	330	$60	$157.2K
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…	5	170	670	$30	$120.6K
99336	N/A	49	70	410	$30	$73K
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…	7	120	130	$80	$61.4K
99335	N/A	36	60	320	$30	$30.1K

Showing 1–10 of 16

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Adam Rodriguez	AZ	Psychiatric/Mental Health Nurse Practitioner	$101.4K	$0
Angel Johnson	AZ	Adult Health Nurse Practitioner	$100K	$0
Autumn Grant	ID	Family Nurse Practitioner	$82.8K	$0
Arti Karmur	AZ	Foot & Ankle Surgery Podiatrist	$45.3K	$950

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Banner Boswell Medical Center	AZ	General Acute Care Hospital	$0	$27M
Succeeding At Recovery LLC	AZ	Substance Use Disorder Rehabilitation Clinic/Center	$0	$18.8M
Banner Imaging Services LLC	AZ	Diagnostic Radiology Physician	$0	$12.9M
S P Gill Md PC	AZ	Medical Specialty Clinic/Center	$0	$9.5M
Maxfar, LLC	AZ	Home Health Agency	$0	$8.9M
Express Urgent Care, PC	AZ	Urgent Care Clinic/Center	$0	$6.6M
Barnet Dulaney Perkins Eye Center, PC	AZ	Ambulatory Surgical Clinic/Center	$2.8M	$1.1M
Bcc West Valley LLC	AZ	Ambulatory Surgical Clinic/Center	$3.5M	$0
Sun City Ophthalmology Asc LLC	AZ	Ambulatory Surgical Clinic/Center	$2M	$1.2M
Baljeet Uppal	AZ	Vascular Surgery Physician	$2.9M	$0

Leading Healthcare, LLC — Billing Profile & Reimbursement Data

Sign up for Leading Healthcare, LLC — Billing Profile & Reimbursement Data policy alerts

Leading Healthcare, LLC — Billing Profile & Reimbursement Data

Sign up for Leading Healthcare, LLC — Billing Profile & Reimbursement Data policy alerts

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References