Banner - University Medical Center Tucson Campus LLC
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 77 procedure codes: 99284 at 5.8× median, 99285 at 5.7× 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 $406.04 per claim for 99284 (Emergency dept visit, high complexity) — 5.8× the national median of $69.51.
Bills $484.12 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 5.7× the national median of $85.65.
Bills $322.65 per claim for 99283 (Emergency dept visit, moderate complexity) — 7.6× the national median of $42.48.
Billing in the top 1% nationally for 1 procedure code: 78452.
This is a statistical summary, not an accusation. See our methodology.
Compared to Clinic/Center, Multi-Specialty Peers
Total spending distribution among 12 providers in this specialty
This provider's total spending of $194.4M is at the 90th percentile among 12 Clinic/Center, Multi-Specialty providers.
Above 90th percentile for this specialty — higher spending than 10 of 12 peers
Total Paid
$194.4M
$194,417,423
Total Claims
3.6M
Beneficiaries
2.5M
1.4 claims/patient
Avg Cost/Claim
$55
#475 of 618K providers by total spending(top <0.1%)
🔍 Analysis
Provider Overview
Banner - University Medical Center Tucson Campus LLC is a Clinic/Center, Multi-Specialty provider based in Tucson, AZ. From the 2018–2024 period, this provider received $194.4M in Medicaid payments across 3.6M claims.
Why This Matters
This provider received $194.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,302 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 (99284 (Emergency dept visit, high complexity)) accounts for 16% of total spending.
$30.2M
74K claims
$406.04
$69.51
Emergency dept visit, high complexity
$30.2M
74K claims · 15.5%
$27.0M
56K claims
$484.12
$85.65
Emergency dept visit, high/urgent complexity
$27.0M
56K claims · 13.9%
$18.8M
58K claims
$322.65
$42.48
Emergency dept visit, moderate complexity
$18.8M
58K claims · 9.7%
Injection, pembrolizumab, 1 mg
$16.4M
2K claims · 8.4%
CT abdomen and pelvis with contrast
$10.7M
17K claims · 5.5%
CT head/brain without contrast
$3.9M
21K claims · 2.0%
$3.4M
2K claims · 1.8%
$3.3M
830 claims · 1.7%
$3.0M
9K claims
$331.79
$54.68
Echocardiography, transthoracic, complete, with Doppler
$3.0M
9K claims · 1.6%
Upper GI endoscopy with biopsy
$3.0M
5K claims · 1.5%
$2.7M
2K claims
$1,642.07
$123.40
Anchor or screw for tissue to bone fixation
$2.7M
2K claims · 1.4%
Emergency dept visit, low complexity
$2.7M
20K claims · 1.4%
$2.7M
37K claims
$71.63
$99.39
Hospital observation service, per hour
$2.7M
37K claims · 1.4%
$2.6M
3K claims
$882.91
$133.68
MRI brain without contrast, then with contrast
$2.6M
3K claims · 1.3%
$2.6M
13K claims
$199.62
$260.56
Intensity modulated radiation treatment delivery, complex
$2.6M
13K claims · 1.3%
$2.5M
628 claims · 1.3%
Comprehensive metabolic panel
$2.4M
195K claims · 1.2%
$1.9M
2K claims
$784.33
$233.73
Polysomnography, sleep study, 6+ hours
$1.9M
2K claims · 1.0%
$1.8M
796 claims · 1.0%
$1.8M
411 claims
$4,445.04
$3,562.28
Nivolumab (Opdivo) injection, 1 mg
$1.8M
411 claims · 0.9%
$1.8M
31K claims
$57.91
$54.77
IV infusion, therapeutic/prophylactic/diagnostic, initial, up to 1 hour
$1.8M
31K claims · 0.9%
$1.6M
1K claims
$1,113.48
$106.14
Myocardial perfusion imaging, SPECT, multiple studies
$1.6M
1K claims · 0.8%
Injection, bevacizumab, 10 mg
$1.5M
439 claims · 0.8%
CT abdomen and pelvis without contrast
$1.5M
3K claims · 0.8%
$1.3M
276 claims · 0.7%
$1.2M
558 claims
$2,194.46
$1,942.13
Injection, trastuzumab, ten milligrams
$1.2M
558 claims · 0.6%
$1.2M
2K claims
$724.25
$255.17
Colonoscopy with polyp removal, snare technique
$1.2M
2K claims · 0.6%
Colonoscopy with biopsy
$1.2M
2K claims · 0.6%
$1.2M
2K claims · 0.6%
$1.2M
2K claims · 0.6%
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