Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerNPI Medicare & MedicaidPearl Medical Practice PLLC
    Ask Trek AI about this page

    Pearl Medical Practice PLLC — Billing Profile & Reimbursement Data

    NPI 1114261203 · Louisville, KY · Primary Care Clinic/Center

    Customize your policy alerts

    Sign up for Pearl Medical Practice PLLC — Billing Profile & Reimbursement Data policy alerts

    Get alerted when relevant policies change without checking for updates manually.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Pearl Medical Practice PLLC is a primary care clinic/center provider located in Louisville, Kentucky. This profile covers 0 Medicare and 72 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.

    Table of contents

    Progress1 / 8

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Provider details (source: NPPES NPI Registry)

    FieldValue
    Entity TypeOrganization
    OrganizationPearl Medical Practice PLLC
    Address4200 Gardiner View Ave
    CityLouisville
    StateKY
    ZIP40213
    TaxonomyPrimary Care Clinic/Center
    NPI EnumeratedNovember 15, 2012

    Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)

    Payer SourceTotal Paid
    Medicaid$4.3M
    Medicare$0

    Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

    Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.

    View: By Year1 / 3

    Medicaid: Complete Services Breakdown

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

    72 rows

    CPT/HCPCS CodeDescriptionClaimsAvg PaidRevenue
    G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…14,630$100$1.5M
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…26,830$40$938.9K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.23,820$40$929K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…12,060$20$277.4K
    G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…1,960$90$172.2K
    U0003Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…4,130$40$156.9K
    99396The provider performs an established well–patient visit for a patient who is between the ages of 40 and 64.1,620$60$97.3K
    99429Use 99429 to report a preventive medicine service that does not have a specific code.430$70$28.6K
    99204The provider sees a new patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the provider…390$70$27.5K
    99441N/A880$20$18.4K

    Showing 1–10 of 72

    • More pages

    Medicaid: Competitive Analysis & Benchmarks

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

    Full comparison — all codes billed, vs. Kentucky median

    72 rows

    CPT/HCPCS CodeDescriptionRankProvider CountMedian ClaimsAvg PaidAverage Revenue
    G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…11502,830$90$1.4M
    G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but…3280990$60$912.2K
    80307The lab analyst performs presumptive drug test(s) via instrumented chemistry analyzers to screen for any number of drug classes on a single date.493402,700$40$673.3K
    U0003Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high…381102,280$50$552.6K
    99213The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…4983,3401,020$30$296K
    99214The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…812,460580$40$245K
    U0005Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc,…46702,800$10$176.1K
    84443The lab analyst performs a test to measure the amount of thyroid–stimulating hormone (TSH), a hormone produced in the pituitary gland that helps regulate thyroid function. The typical specimen is the…1451803,770$10$136.2K
    82306The lab analyst measures the vitamin D level, typically on a serum specimen. This analyte, commonly known as vitamin D, is not really a vitamin, but is an important steroid hormone that is produced…1261502,320$20$120.1K
    87502The lab analyst performs a test to determine the presence of multiple types or subtypes of influenza virus through nucleic acid detection using multiplex amplified probe technique and possibly…158190360$60$119.3K

    Showing 1–10 of 72

    • More pages

    Related Providers

    Other providers that share a Tax Identification Number (TIN) with Pearl Medical Practice PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Osawaru OmoruyiKYFamily Medicine Physician$245.5K$44.2K
    Sheena SteeleKYNurse Practitioner$210.3K$0
    Virginia BonnetteARFamily Nurse Practitioner$150.2K$0
    Naomi EisenbackKYFamily Nurse Practitioner$133.2K$0
    Michelle SchearINNurse Practitioner$132.5K$0
    Joni MilesKYFamily Nurse Practitioner$131.4K$0
    Vicky RaisorKYNurse Practitioner$123.7K$0
    Lori WeisKYNurse Practitioner$111.1K$0
    Joshua GrayKYAdult Health Nurse Practitioner$96.9K$0
    Mark HarrisKYFamily Nurse Practitioner$89.1K$0

    Nearby Providers

    Other providers in the same ZIP code as Pearl Medical Practice PLLC, ranked by combined Medicare and Medicaid revenue.

    ProviderStateTaxonomyMedicare RevenueMedicaid Revenue
    Buena Vida Adhc, LLCKYAdult Day Care Clinic/Center$0$78.3M
    Expanded Horizons Of Kentucky IncKYProfessional Counselor$0$27M
    Day Spring Inc.KYIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility$0$24.7M
    Louisville Optometric Centers Iii, PscKYOptometrist$0$4.6M
    Shanker ChandiramaniKYCardiovascular Disease Physician$327.3K$0
    Terrence DonohueKYInternal Medicine Physician$181.1K$0
    Gregory AbbasKYOtolaryngology Physician$143.6K$0
    Carmel PersonKYInternal Medicine Physician$141.9K$0
    Rod RalloKYOptometrist$95.5K$4.2K
    Carly FranklinKYFamily Nurse Practitioner$30.6K$0

    Frequently Asked Questions

    References

    1. 1.Medicare Physician & Other Practitioner by Provider and Service. CMS.gov.Provider-level Medicare Part B utilization and payment data.
    2. 2.NPPES NPI Registry. CMS.gov.National Provider Identifier registry used for provider enumeration and taxonomy metadata.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    Medicaid Revenue by Year vs. Kentucky Providers
    0 of 7 years billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Claims Volume vs. Kentucky Distribution
    Pearl Medical Practice PLLC — 2 of 25 codes billed far more than typical (above p95)
    p5–p95 (all providers)p25–p75MedianThis providerOutlier
    Rank Distribution — Kentucky