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.

Southwest Kidney Institute, Plc (NPI 1659316008)

Southwest Kidney Institute, Plc is a nephrology physician provider located in Tempe, Arizona. This profile covers 0 Medicare and 27 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	Southwest Kidney Institute, Plc
Address	2141 E Warner Rd
City	Tempe
State	AZ
ZIP	85284
Taxonomy	Nephrology Physician
NPI Enumerated	June 19, 2006

Payer Source	Total Paid
Medicaid	$18.1M
Medicare	$0

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

27 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…	110,490	$50	$5.9M
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	45,810	$100	$4.8M
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…	59,340	$40	$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…	71,930	$30	$2.2M
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…	7,770	$90	$660.2K
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	6,120	$100	$636.7K
90966	The provider manages all the physician related services for one full month for the home dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal disease,…	4,070	$100	$398.6K
76770	A retroperitoneal ultrasound is a noninvasive procedure used to assess the body parts within the abdomen (i.e.Kidneys, urinary bladder, and aorta). This particular code is used when the ultrasound is…	4,630	$60	$273.3K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	9,460	$30	$255.4K
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…	3,420	$50	$184.6K

Showing 1–10 of 27

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

Southwest Kidney Institute, Plc — 7 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

27 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
90960	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease or ESRD. For this service, the…	2	20	380	$140	$1.3M
90961	The provider manages all the services associated with the monthly care of a patient who is 20 years old or older and has a condition known as end stage renal disease, or ESRD. For this service, the…	3	10	1,230	$120	$694.4K
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…	7	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…	142	200	410	$170	$442.7K
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…	62	3,040	750	$50	$343.9K
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…	67	170	960	$40	$295.2K
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…	608	2,780	600	$50	$267K
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…	8	610	610	$50	$258.3K
90966	The provider manages all the physician related services for one full month for the home dialysis care of a patient who is 20 years old or older and has a condition known as end stage renal disease,…	1	10	2,560	$100	$237.9K
90935	Hemodialysis is a procedure that involves drawing blood via an intra–arterial or intravenous catheter, then sieving it through a semi permeable membrane to remove the impurities and finally…	2	20	410	$110	$168.6K

Showing 1–10 of 27

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Ski Ambulatory Surgical Centers, LLC	AZ	Ambulatory Surgical Clinic/Center	$1.1M	$1.7M
Ski Ambulatory Surgical Centers, LLC	AZ	Ambulatory Surgical Clinic/Center	$817K	$1.5M
Ski Ambulatory Surgical Centers, LLC	AZ	Ambulatory Surgical Clinic/Center	$487.2K	$993.8K
Nandini Sharma	AZ	Nephrology Physician	$371.1K	$0
Mandip Kang	AZ	Nephrology Physician	$307.6K	$17.3K
Shailesh Patel	AZ	Nephrology Physician	$292.7K	$0
Theodore Tzeremas	AZ	Nephrology Physician	$277.8K	$0
Bindu Jayavelu	AZ	Nephrology Physician	$250.1K	$0
Richard Flick	AZ	Nephrology Physician	$248.2K	$0
Luyi De Prada	AZ	Nephrology Physician	$244.2K	$0

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Devoted Guardians LLC	AZ	In Home Supportive Care Agency	$0	$82.1M
Happy Kids Pediatrics P.C.	AZ	Pediatrics Physician	$0	$50.5M
Cranial Technologies, Inc.	AZ	Prosthetic/Orthotic Supplier	$0	$50.4M
Helping Hands Health Services	AZ	Community/Behavioral Health Agency	$0	$21.5M
1 Family Clinic LLC	AZ	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$12.1M
Southwest Kidney Davita Dialysis Partners LLC	AZ	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$8.3M
Mariposa Speech Services LLC	AZ	Physical Therapy Clinic/Center	$0	$6.3M
Rezwan Chowdhury	AZ	Radiation Oncology Physician	$1.1M	$0
Edward Park	AZ	Nephrology Physician	$230.1K	$0
Anup Rai	AZ	Nephrology Physician	$211.8K	$0

Southwest Kidney Institute, Plc — Billing Profile & Reimbursement Data

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Southwest Kidney Institute, Plc — 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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