Phoenix Children's Hospital
General Acute Care Hospital Children
Phoenix, Arizona
NPI: 1760480503
Risk Tier
High
Total Paid
$555.7M
$555,705,726
Total Claims
4.2M
Beneficiaries
3.6M
Avg Cost/Claim
$132.77
Active billing period: 84 months (2018-01 to 2024-12)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $356.51 per claim for 99283 (Emergency dept visit, moderate complexity), which is 8.4× the national median of $42.48.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 209 procedure codes: 99284 at 9.1× median, 99285 at 10.6× median.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024