Maricopa County Special Health Care District
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 123 procedure codes: 99283 at 8.1× median, 99285 at 7.1× median.
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Rate Outlier
Rate Outlier means this provider charges above the 90th percentile for multiple different procedure codes simultaneously. While one high-cost code could reflect specialization, consistently high rates across many codes may indicate systematic overbilling.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Risk Assessment
Bills $346.15 per claim for 99283 (Emergency dept visit, moderate complexity) — 8.2× the national median of $42.48.
Bills $608.17 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 7.1× the national median of $85.65.
Bills $996.11 per claim for 74177 (CT abdomen and pelvis with contrast) — 15.2× the national median of $65.76.
Billing in the top 1% nationally for 10 procedure codes: 99285, 74177, 99284.
This is a statistical summary, not an accusation. See our methodology.
Compared to General Acute Care Hospital Peers
Total spending distribution among 156 providers in this specialty
This provider's total spending of $251.5M is at the 50th percentile among 156 General Acute Care Hospital providers.
Total Paid
$251.5M
$251,457,853
Total Claims
4.6M
Beneficiaries
4.0M
1.2 claims/patient
Avg Cost/Claim
$55
#329 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Maricopa County Special Health Care District is a General Acute Care Hospital provider based in Phoenix, AZ. From the 2018–2024 period, this provider received $251.5M in Medicaid payments across 4.6M claims.
Important Context
- ℹ️This is a government entity that may serve as a fiscal agent for large populations. Government providers often bill at high volumes due to the scale of public programs they administer.
Why This Matters
This provider received $251.5M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 31,432 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 30 distinct procedure codes. The top code (99283 (Emergency dept visit, moderate complexity)) accounts for 18% of total spending.
$45.6M
132K claims
$346.15
$42.48
Emergency dept visit, moderate complexity
$45.6M
132K claims · 18.1%
$29.9M
49K claims
$608.17
$85.65
Emergency dept visit, high/urgent complexity
$29.9M
49K claims · 11.9%
CT abdomen and pelvis with contrast
$29.4M
30K claims · 11.7%
$23.0M
49K claims
$470.01
$69.51
Emergency dept visit, high complexity
$23.0M
49K claims · 9.1%
Emergency dept visit, low complexity
$18.6M
90K claims · 7.4%
CT head/brain without contrast
$10.7M
27K claims · 4.3%
Upper GI endoscopy with biopsy
$4.0M
3K claims · 1.6%
CT cervical spine without contrast
$3.9M
9K claims · 1.6%
$3.7M
13K claims
$295.23
$79.28
Duplex scan of arterial inflow and venous outflow, complete
$3.7M
13K claims · 1.5%
$3.6M
14K claims
$248.92
$121.16
Clinic visit/encounter, all-inclusive
$3.6M
14K claims · 1.4%
$3.5M
37K claims
$94.59
$99.39
Hospital observation service, per hour
$3.5M
37K claims · 1.4%
$3.1M
8K claims
$393.94
$54.68
Echocardiography, transthoracic, complete, with Doppler
$3.1M
8K claims · 1.2%
Therapeutic exercises, each 15 min
$2.9M
40K claims · 1.1%
$2.7M
4K claims
$714.65
$60.19
CT abdomen and pelvis without contrast
$2.7M
4K claims · 1.1%
$2.6M
394 claims · 1.0%
Case management, each 15 min
$2.2M
25K claims · 0.9%
$2.2M
15K claims
$139.89
$52.03
Emergency dept visit, minimal complexity
$2.2M
15K claims · 0.9%
CT angiography, chest, with contrast
$2.1M
6K claims · 0.8%
Comprehensive metabolic panel
$2.0M
192K claims · 0.8%
$1.9M
114K claims
$17.06
$53.41
Office/outpatient visit, est. patient, mod-high complexity
$1.9M
114K claims · 0.8%
$1.8M
14K claims · 0.7%
Colonoscopy with biopsy
$1.8M
2K claims · 0.7%
$1.7M
126K claims
$13.59
$37.81
Office/outpatient visit, est. patient, low-mod complexity
$1.7M
126K claims · 0.7%
$1.6M
2K claims
$1,002.46
$123.40
Anchor or screw for tissue to bone fixation
$1.6M
2K claims · 0.6%
$1.6M
3K claims
$574.30
$133.68
MRI brain without contrast, then with contrast
$1.6M
3K claims · 0.6%
$1.5M
218 claims · 0.6%
$1.4M
3K claims · 0.6%
Hospital outpatient clinic visit
$1.2M
99K claims · 0.5%
$1.1M
663 claims
$1,623.08
$101.24
Critical care, first 30-74 minutes
$1.1M
663 claims · 0.4%
$1.0M
879 claims · 0.4%
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