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 1538535158)

Smsj Tucson Holdings LLC is a general acute care hospital provider located in Tucson, Arizona. This profile covers 0 Medicare and 267 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	350 N Wilmot Rd
City	Tucson
State	AZ
ZIP	85711
Taxonomy	General Acute Care Hospital
NPI Enumerated	August 18, 2015

Payer Source	Total Paid
Medicaid	$28.9M
Medicare	$0

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

267 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
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.	31,390	$220	$7M
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.	27,910	$190	$5.4M
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.	6,160	$500	$3.1M
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.	13,290	$190	$2.5M
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.	8,500	$170	$1.5M
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.	2,630	$430	$1.1M
72125	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the cervical spine without contrast material.	3,410	$210	$698.4K
71260	In this diagnostic procedure, the provider performs a computed tomography, or CT, examination of the thorax using contrast material.	2,870	$210	$613.8K
97110	Therapeutic exercise is a form of physical therapy that utilizes specially designed exercises and activities to help patients gain better mobility and fitness levels. Normally used on patients with…	12,790	$50	$588.3K
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.	1,490	$370	$552.8K

Showing 1–10 of 267

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

267 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.	72	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.	47	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.	45	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.	46	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…	37	110	960	$70	$1.7M
47562	The provider removes the gallbladder through a laparoscope, a tubular instrument with a light source and camera inserted through the abdominal wall, to treat gallbladder disease.	27	30	70	$3,620	$999.9K
G0378	Hospital observation service, per hour	35	80	6,320	$70	$961.9K
87801	The lab analyst performs a test for multiple infectious agents using amplified nucleic acid probe technique.	22	20	250	$40	$915.9K
C1713	Anchor/screw for opposing bone-to-bone or soft tissue-to-bone (implantable)	30	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.	52	150	1,040	$240	$764.4K

Showing 1–10 of 267

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
United Cerebral Palsy Of Southern Arizona, Inc	AZ	Home Health Agency	$0	$131.1M
Arizona Consumer Direct Personal Care	AZ	Home Health Agency	$0	$121.6M
Southern Arizona Family Services, Inc.	AZ	In Home Supportive Care Agency	$0	$28.5M
Cope Community Services, Inc.	AZ	Methadone Clinic	$0	$27.5M
Dependable Nurses, Inc.	AZ	Home Health Agency	$0	$26.5M
Radiology Ltd., LLC	AZ	Diagnostic Radiology Physician	$0	$24.2M
Intermountain Health Center Inc	AZ	Multi-Specialty Clinic/Center	$0	$22.9M
Arizona Community Physicians PC	AZ	Internal Medicine Physician	$0	$22.5M
Marana Health Center, Inc	AZ	Federally Qualified Health Center (FQHC)	$0	$15.2M
Maxim Healthcare Services, Inc.	AZ	Home Health Agency	$0	$15.1M

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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