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Phoenix Children's Hospital

Pediatrics·Phoenix, AZ·NPI: 1922112044Share

Compared to Pediatrics Peers

Total spending distribution among 14 providers in this specialty

P25MedianP75P90

This provider's total spending of $162.4M is at the 75th percentile among 14 Pediatrics providers.

Active Billing Period:2018-012024-12(84 months)

Total Paid

$162.4M

$162,374,551

Total Claims

2.8M

Beneficiaries

2.4M

1.1 claims/patient

Avg Cost/Claim

$59

#630 of 618K providers by total spending(top 0.1%)

🔍 Analysis

Provider Overview

Phoenix Children's Hospital is a Pediatrics provider based in Phoenix, AZ. From the 2018–2024 period, this provider received $162.4M in Medicaid payments across 2.8M claims.

Why This Matters

This provider received $162.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 20,296 Medicaid beneficiaries for a full year at average per-enrollee costs.

19% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$21.4M
+11%
2019
$23.6M
-30%
2020
$16.6M
+39%
2021
$23.1M
+7%
2022
$24.7M
+11%
2023
$27.4M
-7%
2024
$25.5M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99214 (Office/outpatient visit, est. patient, mod-high complexity)) accounts for 11% of total spending.

99214Normal range

Office/outpatient visit, est. patient, mod-high complexity

$17.1M

248K claims · 10.5%

Your Cost: $68.89/claim|Median: $53.41
1.3× median
99283Normal range

Emergency dept visit, moderate complexity

$13.8M

234K claims · 8.5%

Your Cost: $59.13/claim|Median: $42.48
1.4× median
99284Top 25%

Emergency dept visit, high complexity

$11.0M

106K claims · 6.8%

Your Cost: $104.41/claim|Median: $69.51
1.5× median
99213Normal range

Office/outpatient visit, est. patient, low-mod complexity

$10.4M

204K claims · 6.4%

Your Cost: $51.07/claim|Median: $37.81
1.4× median
99232Top 5%

Subsequent hospital care, per day, moderate complexity

$8.4M

134K claims · 5.2%

Your Cost: $62.79/claim|Median: $23.99
2.6× median
99215Normal range

Office/outpatient visit, high complexity

$8.0M

90K claims · 5.0%

Your Cost: $89.23/claim|Median: $74.09
1.2× median
99233Top 5%

Subsequent hospital care, per day, high complexity

$7.8M

85K claims · 4.8%

Your Cost: $91.52/claim|Median: $35.30
2.6× median
92014Top 5%

Ophthalmological exam, comprehensive, established patient

$6.6M

55K claims · 4.0%

Your Cost: $120.25/claim|Median: $47.08
2.5× median
99244Normal range

Office or other outpatient consultation, moderate complexity

$5.7M

40K claims · 3.5%

Your Cost: $143.12/claim|Median: $121.58
1.2× median
92004Top 5%

Ophthalmological exam, comprehensive, new patient

$5.6M

38K claims · 3.5%

Your Cost: $149.36/claim|Median: $59.72
2.5× median
99243Top 25%

Office or other outpatient consultation, low complexity

$3.6M

36K claims · 2.2%

Your Cost: $99.05/claim|Median: $82.43
1.2× median
92012Top 5%

Ophthalmological exam, intermediate, established patient

$3.3M

38K claims · 2.1%

Your Cost: $86.83/claim|Median: $38.23
2.3× median
90460Top 10%

Immunization administration, first vaccine/toxoid, with counseling

$3.1M

73K claims · 1.9%

Your Cost: $42.23/claim|Median: $17.85
2.4× median
99285Top 25%

Emergency dept visit, high/urgent complexity

$3.0M

19K claims · 1.8%

Your Cost: $155.65/claim|Median: $85.65
1.8× median
99282Normal range

Emergency dept visit, low complexity

$2.6M

71K claims · 1.6%

Your Cost: $37.43/claim|Median: $37.72
1.0× median
88305Top 5%

Surgical pathology, gross and microscopic examination

$2.6M

14K claims · 1.6%

Your Cost: $179.18/claim|Median: $35.80
5.0× median
93303Normal range

Echocardiography, transthoracic, limited

$2.5M

35K claims · 1.5%

Your Cost: $70.84/claim|Median: $112.83
0.6× median
99472Normal range

Subsequent pediatric critical care, per day, age 2-5

$1.9M

5K claims · 1.2%

Your Cost: $356.63/claim|Median: $307.98
1.2× median
92015Top 25%

Determination of refractive state

$1.8M

91K claims · 1.1%

Your Cost: $19.75/claim|Median: $10.36
1.9× median
99203Normal range

Office/outpatient visit, new patient, low-mod complexity

$1.8M

29K claims · 1.1%

Your Cost: $60.69/claim|Median: $57.85
1.1× median
93306Normal range

Echocardiography, transthoracic, complete, with Doppler

$1.7M

23K claims · 1.1%

Your Cost: $74.14/claim|Median: $54.68
1.4× median
99291Top 25%

Critical care, first 30-74 minutes

$1.6M

9K claims · 1.0%

Your Cost: $187.85/claim|Median: $101.24
1.9× median
97110Top 25%

Therapeutic exercises, each 15 min

$1.5M

27K claims · 0.9%

Your Cost: $57.57/claim|Median: $24.49
2.4× median
99392Normal range

Preventive medicine, established patient, age 1-4

$1.5M

18K claims · 0.9%

Your Cost: $84.23/claim|Median: $75.18
1.1× median
99391Normal range

Preventive medicine, established patient, infant (under 1)

$1.5M

18K claims · 0.9%

Your Cost: $81.38/claim|Median: $69.35
1.2× median
99239Top 10%

Hospital discharge day management, more than 30 minutes

$1.5M

15K claims · 0.9%

Your Cost: $95.58/claim|Median: $43.85
2.2× median
95720Top 25%

$1.2M

6K claims · 0.8%

Your Cost: $193.07/claim|Median: $120.95
1.6× median
99222Top 5%

Initial hospital care, per day, moderate complexity

$1.2M

10K claims · 0.7%

Your Cost: $119.61/claim|Median: $51.25
2.3× median
70551Normal range

MRI brain without contrast

$1.2M

19K claims · 0.7%

Your Cost: $62.17/claim|Median: $85.39
0.7× median
99204Normal range

Office/outpatient visit, new patient, mod-high complexity

$1.1M

12K claims · 0.7%

Your Cost: $93.95/claim|Median: $84.03
1.1× median