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.

Summit Healthcare Medical Associates (NPI 1467878108)

Summit Healthcare Medical Associates is a family medicine physician provider located in Show Low, Arizona. This profile covers 0 Medicare and 108 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	Summit Healthcare Medical Associates
Address	4951 S White Mountain Rd Bldg A
City	Show Low
State	AZ
ZIP	85901
Taxonomy	Family Medicine Physician
NPI Enumerated	March 5, 2014

Payer Source	Total Paid
Medicaid	$15.5M
Medicare	$0

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

108 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…	72,590	$60	$4.4M
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.	34,740	$90	$3.1M
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…	54,250	$50	$2.5M
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.	19,180	$120	$2.3M
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.	15,070	$50	$738.5K
90837	In this service, the provider performs psychotherapy, a series of technique for treating the psychiatric disorders of the patient. The treatment session typically lasts for a minimum of 53 minutes or…	2,700	$120	$318.1K
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…	3,430	$90	$298.1K
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…	3,650	$70	$240.8K
T1015	Clinic visit/encounter, all-inclusive	1,050	$210	$218.8K
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…	3,030	$70	$218.2K

Showing 1–10 of 108

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

Summit Healthcare Medical Associates — 2 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

108 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1015	Clinic visit/encounter, all-inclusive	228	360	3,640	$230	$7.7M
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.	62	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.	43	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.	72	260	2,600	$170	$2.6M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	132	160	1,640	$110	$710.7K
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…	441	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…	140	200	410	$170	$442.7K
99211	An established patient presents for an office or other outpatient visit that may not require the presence of a physician or other qualified healthcare professional.	115	400	200	$120	$403K
43239	The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis.	124	180	590	$250	$360.9K
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…	46	3,040	750	$50	$343.9K

Showing 1–10 of 108

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Summit Healthcare Association	AZ	Rural Acute Care Hospital	$0	$50.7M
Somc Medical Care Foundation, Inc.	OH	Family Medicine Physician	$0	$25.3M
Basel Shoua	AZ	Hematology & Oncology Physician	$1.4M	$0
Subhakar Mutyala	AZ	Radiation Oncology Physician	$1.1M	$0
Tam Nguyen	AZ	Radiation Oncology Physician	$1M	$0
Joseph Rosen	AZ	Medical Oncology Physician	$978.5K	$0
Steven Sckolnik	AZ	Radiation Oncology Physician	$957.8K	$0
Riyaz Sumar	AZ	Cardiovascular Disease Physician	$538.4K	$0
Ernesto Gomez	AZ	Obstetrics & Gynecology Physician	$532.6K	$0
Veronica Rodriguez-romero	NV	Family Nurse Practitioner	$531.9K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Changepoint Integrated Health	AZ	Community/Behavioral Health Agency	$0	$15.7M
Guardian Flight LLC	AZ	Air Ambulance	$389.9K	$3.5M
Guardian Flight LLC	AZ	Air Ambulance	$663.5K	$3.1M
Travis Hamblin	AZ	Dermatology Physician	$1.1M	$0
Barnet Dulaney Perkins Eye Center, PC	AZ	Ambulatory Surgical Clinic/Center	$783.1K	$267.4K
Alliance Healthcare Services Inc	AZ	Mobile Radiology Clinic/Center	$461.8K	$0
John Knippers	AZ	Ophthalmology Physician	$373.8K	$0
Leon Driss	AZ	Internal Medicine Physician	$259.6K	$0
Milton Randall	AZ	Physical Therapist	$245K	$0
Peter Niemczyk	AZ	Urology Physician	$210.5K	$0

Summit Healthcare Medical Associates — Billing Profile & Reimbursement Data

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Summit Healthcare Medical Associates — 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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