Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Arkansas for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Arkansas only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Arkansas (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Pinnacle In Home Care, LLC (NPI 1063986875)

Field	Value
Entity Type	Organization
Organization	Pinnacle In Home Care, LLC
Address	213 W Monroe Ave Ste L
City	Lowell
State	AR
ZIP	72745
Taxonomy	In Home Supportive Care Agency
NPI Enumerated	January 15, 2019

Payer Source	Total Paid
Medicaid	$18M
Medicare	$0

Key Findings

PINNACLE IN HOME CARE, LLC is effectively a single-payer Medicaid provider with no Medicare billing on file (none) and $18M in lifetime Medicaid revenue, and its NPI was enumerated on 2019-01-15 (~7 years ago), indicating several years of operational history concentrated on state Medicaid business.

Revenue is highly concentrated: the precomputed top 3 Medicaid codes account for 98.7% of this provider's total Medicaid revenue, which indicates the organization’s financial performance is heavily dependent on a very small set of service lines.

Two codes dominate the revenue mix and define the business model: T1019 (165.9K claims, $71 avg paid/claim, $11.8M revenue; 65.3% of Medicaid revenue) and S5125 (89K claims, $65 avg paid/claim, $5.8M revenue; 32.1% of Medicaid revenue). These codes are both per-15-minute personal/attendant care services, which implies a labor- and time-based, in-home supportive care operation focused on billed minutes rather than episodic clinical procedures.

Competitive standing on T1019 is strong: the provider ranks #7 of 139 in-state (96th percentile) and the data labels this as notably above typical state volume, signaling that PINNACLE is a high-volume state participant for personal care services.

On S5125 the provider ranks #2 of 75 in-state (99th percentile); the dataset nevertheless annotates that this is a typical, unremarkable volume for this code, which suggests that while PINNACLE is among the largest billers for attendant care in the state, similar high volumes are observed among other top providers.

Ancillary codes represent a very small share of revenue: T1017 (10.4K claims, $23 avg paid/claim, $238.2K revenue; 1.3% of Medicaid revenue) ranks #19 of 91 (80th percentile) and S5150 (3.5K claims, $65 avg paid/claim, $227.2K revenue; 1.3% of Medicaid revenue) ranks #2 of 14 (92th percentile), both characterized as typical, unremarkable volumes and indicating these services are secondary to the core personal/attendant care business.

Operationally, the per-15-minute billing profile (T1019 and S5125) points to a staffing- and scheduling-intensive model where revenue scales with billed minutes; this concentration makes the provider sensitive to changes in Medicaid reimbursement policy, care-plan authorization patterns, or reductions in authorized service minutes, particularly because there is no Medicare revenue to diversify reimbursement risk.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

4 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	165,950	$70	$11.8M
S5125	Attendant care services; per 15 minutes	89,020	$70	$5.8M
T1017	Targeted case management, each 15 minutes	10,360	$20	$238.2K
S5150	Unskilled respite care, not hospice; per 15 minutes	3,500	$70	$227.2K

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Arkansas providers billing the same CPT/HCPCS codes.

Claims Volume vs. Arkansas Distribution

Pinnacle In Home Care, LLC — 2 of 4 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Arkansas

Full comparison — all codes billed, vs. Arkansas median

4 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
T1019	Personal care services, per 15 minutes, not for an inpatient or resident of a hospital, nursing facility, icf/mr or imd, part of the individualized plan of treatment (code may not be used to identify…	7	140	18,150	$60	$2.5M
S5125	Attendant care services; per 15 minutes	2	80	4,280	$80	$1.7M
T1017	Targeted case management, each 15 minutes	19	90	1,830	$20	$206.4K
S5150	Unskilled respite care, not hospice; per 15 minutes	2	10	960	$90	$160.1K

Nearby Providers

Other providers in the same ZIP code as Pinnacle In Home Care, LLC, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Taxsavers, Inc.	AR	In Home Supportive Care Agency	$0	$4.9M
Laura Neal	AR	Family Nurse Practitioner	$637.3K	$0
Roy Sampson	AR	Rheumatology Physician	$378.7K	$0
Terryl Ortego	AR	Gastroenterology Physician	$67.8K	$0
Amanda Hawes	AR	Physician Assistant	$18K	$0
Christopher Kelsey	AR	Occupational Therapist	$10.9K	$0

Pinnacle In Home Care, LLC — Billing Profile & Reimbursement Data

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Pinnacle In Home Care, LLC — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Nearby Providers

Frequently Asked Questions

References