Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Banner Desert Medical Center

General Acute Care Hospital·Mesa, AZ·NPI: 1720011810SharePrint Report
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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:

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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

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Bills $510.09 per claim for 99285 (Emergency dept visit, high/urgent complexity) — 6.0× the national median of $85.65.

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Bills $326.77 per claim for 99284 (Emergency dept visit, high complexity) — 4.7× the national median of $69.51.

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Bills $282.43 per claim for 99283 (Emergency dept visit, moderate complexity) — 6.7× the national median of $42.48.

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Billing in the top 1% nationally for 4 procedure codes: 99291, 70496, 92552.

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

P25MedianP75P90

This provider's total spending of $199.6M is at the 50th percentile among 156 General Acute Care Hospital providers.

Active Billing Period:2018-01→2024-12(84 months)

Total Paid

$199.6M

$199,618,075

Total Claims

3.9M

Beneficiaries

3.0M

1.3 claims/patient

Avg Cost/Claim

$52

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

🔍 Analysis

Provider Overview

Banner Desert Medical Center is a General Acute Care Hospital provider based in Mesa, AZ. From the 2018–2024 period, this provider received $199.6M in Medicaid payments across 3.9M claims.

Why This Matters

This provider received $199.6M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 24,952 Medicaid beneficiaries for a full year at average per-enrollee costs.

↓ 31% growthsince first billing year

Monthly Spending Trend

Yearly Spending

2018
$34.2M
-5%
2019
$32.4M
-23%
2020
$25.1M
+14%
2021
$28.6M
-6%
2022
$26.8M
+8%
2023
$28.8M
-17%
2024
$23.8M

Procedure Breakdown

Cost per claim compared to national benchmarks

This provider bills for 30 distinct procedure codes. The top code (99285 (Emergency dept visit, high/urgent complexity)) accounts for 23% of total spending.

99285Top 5%

Emergency dept visit, high/urgent complexity

$46.6M

91K claims · 23.3%

Your Cost: $510.09/claim|Median: $85.65
6.0× median
99284Top 5%

Emergency dept visit, high complexity

$42.0M

128K claims · 21.0%

Your Cost: $326.77/claim|Median: $69.51
4.7× median
99283Top 5%

Emergency dept visit, moderate complexity

$28.5M

101K claims · 14.3%

Your Cost: $282.43/claim|Median: $42.48
6.7× median
74177Top 5%

CT abdomen and pelvis with contrast

$16.4M

21K claims · 8.2%

Your Cost: $785.21/claim|Median: $65.76
11.9× median
74176Top 5%

CT abdomen and pelvis without contrast

$6.8M

13K claims · 3.4%

Your Cost: $523.69/claim|Median: $60.19
8.7× median
44970Top 10%

$6.3M

1K claims · 3.1%

Your Cost: $4,469.64/claim|Median: $1,699.18
2.6× median
70450Top 25%

CT head/brain without contrast

$5.0M

35K claims · 2.5%

Your Cost: $142.46/claim|Median: $45.53
3.1× median
C1713Top 10%

$4.4M

3K claims · 2.2%

Your Cost: $1,355.89/claim|Median: $123.40
11.0× median
47562Top 5%

$3.9M

945 claims · 2.0%

Your Cost: $4,142.54/claim|Median: $731.87
5.7× median
99282Top 25%

Emergency dept visit, low complexity

$3.8M

30K claims · 1.9%

Your Cost: $125.35/claim|Median: $37.72
3.3× median
72125Top 10%

CT cervical spine without contrast

$2.6M

12K claims · 1.3%

Your Cost: $205.38/claim|Median: $32.30
6.4× median
G0378Normal range

Hospital observation service, per hour

$2.3M

67K claims · 1.1%

Your Cost: $34.33/claim|Median: $99.39
0.3× median
99291Top 1%

Critical care, first 30-74 minutes

$2.2M

2K claims · 1.1%

Your Cost: $1,023.51/claim|Median: $101.24
10.1× median
70553Top 5%

MRI brain without contrast, then with contrast

$1.6M

2K claims · 0.8%

Your Cost: $691.04/claim|Median: $133.68
5.2× median
93306Top 10%

Echocardiography, transthoracic, complete, with Doppler

$1.3M

5K claims · 0.6%

Your Cost: $277.01/claim|Median: $54.68
5.1× median
70496Top 1%

$1.3M

2K claims · 0.6%

Your Cost: $549.96/claim|Median: $78.92
7.0× median
95810Top 10%

Polysomnography, sleep study, 6+ hours

$1.3M

2K claims · 0.6%

Your Cost: $739.84/claim|Median: $233.73
3.2× median
74174Top 5%

$1.2M

1K claims · 0.6%

Your Cost: $899.40/claim|Median: $89.41
10.1× median
L8699Normal range

$1.0M

1K claims · 0.5%

Your Cost: $1,019.32/claim|Median: $389.88
2.6× median
92552Top 1%

$932K

3K claims · 0.5%

Your Cost: $284.62/claim|Median: $12.63
22.5× median
88305Top 25%

Surgical pathology, gross and microscopic examination

$893K

11K claims · 0.4%

Your Cost: $82.27/claim|Median: $35.80
2.3× median
71275Normal range

CT angiography, chest, with contrast

$834K

9K claims · 0.4%

Your Cost: $94.11/claim|Median: $92.96
1.0× median
42820Top 25%

Tonsillectomy and adenoidectomy, under age 12

$830K

355 claims · 0.4%

Your Cost: $2,337.82/claim|Median: $331.68
7.0× median
43239Top 25%

Upper GI endoscopy with biopsy

$817K

3K claims · 0.4%

Your Cost: $317.84/claim|Median: $151.68
2.1× median
72131Top 5%

$798K

2K claims · 0.4%

Your Cost: $367.84/claim|Median: $42.82
8.6× median
J1745Top 25%

Injection, infliximab, excludes biosimilar, 10 mg

$789K

290 claims · 0.4%

Your Cost: $2,719.17/claim|Median: $1,587.53
1.7× median
95811Top 25%

$730K

1K claims · 0.4%

Your Cost: $639.95/claim|Median: $255.03
2.5× median
80053Normal range

Comprehensive metabolic panel

$714K

178K claims · 0.4%

Your Cost: $4.02/claim|Median: $7.24
0.6× median
99213Top 5%

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

$700K

6K claims · 0.4%

Your Cost: $122.52/claim|Median: $37.81
3.2× median
99214Top 1%

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

$552K

3K claims · 0.3%

Your Cost: $219.65/claim|Median: $53.41
4.1× median

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