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.

Banner Childrens Banner Health Clinic LLC (NPI 1407191216)

Banner Childrens Banner Health Clinic LLC is a primary care clinic/center provider located in Phoenix, Arizona. This profile covers 0 Medicare and 84 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	Banner Childrens Banner Health Clinic LLC
Address	2901 N Central Ave Ste 160
City	Phoenix
State	AZ
ZIP	85012
Taxonomy	Primary Care Clinic/Center
NPI Enumerated	December 5, 2012

Payer Source	Total Paid
Medicaid	$29.6M
Medicare	$0

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

84 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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…	90,880	$80	$7.5M
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…	107,710	$60	$6.2M
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.	86,940	$40	$3.8M
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…	38,520	$90	$3.3M
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…	33,210	$90	$3M
99393	The provider performs an established well–patient visit for a child who is between the ages of 5 and 11.	21,710	$90	$2M
90461	In this procedure, the provider administers an additional live attenuated vaccine either via a parenteral, oral, intranasal, intramuscular, or intravenous to a patient up to 18 years of age after the…	29,430	$40	$1.1M
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	8,020	$100	$801.8K
90471	In this procedure, the provider administers a live attenuated vaccine using a percutaneous, intradermal, subcutaneous, or intramuscular route.	17,380	$20	$330.2K
99381	The provider performs a well–baby visit for a child under the age of one.	2,930	$100	$283.9K

Showing 1–10 of 84

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

Banner Childrens Banner Health Clinic LLC — 14 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

84 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
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…	36	3,040	750	$50	$343.9K
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…	19	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.	4	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…	5	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…	4	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…	591	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.	4	310	470	$60	$131.9K
99215	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a high level of medical decision making, and/or the…	791	930	200	$70	$97.7K
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…	727	1,160	150	$90	$96.5K
99394	The provider performs an established well–patient visit for an adolescent who is between the ages of 12 and 17.	12	300	270	$60	$90.1K

Showing 1–10 of 84

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Mountain Park Health Center	AZ	Federally Qualified Health Center (FQHC)	$0	$351.5M
The Tungland Company, LLC	AZ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$332M
Adelante Healthcare, Inc.	AZ	Federally Qualified Health Center (FQHC)	$0	$245.5M
Banner-university Medical Group	AZ	Multi-Specialty Clinic/Center	$0	$133.7M
Prileo Healthcare LLC Dba Prileo Home Care	AZ	In Home Supportive Care Agency	$0	$88.8M
Denova Collaborative Health, LLC	AZ	Multi-Specialty Clinic/Center	$0	$87.9M
Southwest Behavioral Health Services Inc	AZ	Community/Behavioral Health Agency	$0	$83.5M
Terros, Inc.	AZ	Community/Behavioral Health Agency	$0	$81.7M
Accentcare At Home, Inc.	AZ	In Home Supportive Care Agency	$0	$65.7M
Banner Physician Super Specialists Arizona LLC	AZ	Multi-Specialty Clinic/Center	$0	$36.9M

Banner Childrens Banner Health Clinic LLC — Billing Profile & Reimbursement Data

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Banner Childrens Banner Health Clinic 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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References